Experimental or Investigational Treatment definition

Experimental or Investigational Treatment means any drug, device, therapy, medical treatment or procedure which involves the application, administration or use of procedures, techniques, equipment, supplies, products, remedies, vaccines, biological products, drugs, pharmaceuticals or chemical compounds if, as determined solely by the Health Plan: The drug or device cannot be lawfully marketed without approval of the U.S. Food and Drug Administration and approval for marketing has not been given at the time the drug or device is furnished; The drug, device, therapy, medical treatment, or procedure, or the patient informed consent document utilized with the drug, device, medical treatment or procedure, was reviewed and approved by the treating facility's Institutional Review Board or other board serving a similar function, or if federal law requires such review and approval; Reliable Evidence (as that term is defined below) shows that such drug, device, therapy, medical treatment, or procedure has not been proven safe and effective for the treatment of the condition in question, using generally accepted scientific, medical, or public health methodologies or statistical practices;Reliable Evidence shows that the drug, device, therapy, medical treatment, or procedure is the subject of on-going phase I or phase II clinical trials; is the research, experimental, study or investigational arm of on-going phase III clinical trials; or is otherwise under study to determine its maximum tolerated dose, its toxicity, safety, or efficacy as compared with a standard means of treatment or diagnosis; or Reliable Evidence shows that the prevailing opinion among experts regarding the drug, device, therapy, medical treatment, or procedure is that further studies or clinical trials are necessary to determine its maximum tolerated dose, its toxicity, its safety, its efficacy, or its efficacy as compared with a standard means of treatment or diagnosis or the prevailing opinion among experts as demonstrated by Reliable Evidence is that usage should be substantially confined to research settings.
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Experimental or Investigational Treatment means medical treatment, services, supplies, medications, drugs, or other methods of therapy or medical practices, which are not accepted as a valid course of treatment by the Utah Medical Association, the U.S. Food and Drug Administration, the American Medical Association, or the Surgeon General.
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Experimental or Investigational Treatment means medical, surgical, diagnostic, or other health care services, treatments, procedures, technologies, supplies, devices, drug therapies, or medications that, after consultation with a medical professional, we determine to be any one of the following:
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Examples of Experimental or Investigational Treatment in a sentence

  • An Expedited Experimental or Investigational Treatment External Review (EEIER) request if the Adverse Determination involves a denial of coverage based on the a determination that the recommended or requested service or treatment is experimental or investigational and the Insured Person’s treating Physician certifies in writing that the recommended or requested service or treatment would be significantly less effective if not promptly initiated.

  • Standard Experimental or Investigational Treatment External Review (SEIER) ProcessAn Insured Person, or an Insured Person’s Authorized Representative, may submit a request for an Experimental or Investigational External Review when the denial of coverage is based on a determination that the recommended or requested health care service or treatment is experimental or investigational.

  • Expedited Experimental or Investigational Treatment External Review (EEIER) ProcessAn Insured Person, or an Insured Person’s Authorized Representative, may submit an oral request for an Expedited Experimental or Investigational External Review when: 1.

  • An Expedited Experimental or Investigational Treatment External Review (EEIER) request if the Adverse Determination involves a denial of coverage based on a determination that the recommended or requested service or treatment is experimental or investigational and the Insured Person’s treating Physician certifies in writing that the recommended or requested service or treatment would be significantly less effective if not promptly initiated.

  • Such junior employees who have lost their positions as a result of a bump shall have the right to exercise their seniority in the same manner as if their jobs had been eliminated.

  • Expedited Experimental or Investigational Treatment External Review (EEIER) Process An Insured Person, or an Insured Person’s Authorized Representative, may submit an oral request for an Expedited Experimental or Investigational External Review when: 1.

  • Standard Experimental or Investigational Treatment External Review (SEIER) Process An Insured Person, or an Insured Person’s Authorized Representative, may submit a request for an Experimental or Investigational External Review when the denial of coverage is based on a determination that the recommended or requested health care service or treatment is experimental or investigational.

  • Expedited Experimental or Investigational Treatment External Review (EEIER) ProcessAn Insured Person, or an Insured Person’s Authorized Representative, may submit an oral request for an ExpeditedExperimental or Investigational External Review when: 1.

  • An Expedited Experimental or Investigational Treatment External Review (EEIER) request if the Adverse Benefit Determination involves a denial of coverage based on the a determination that the recommended or requested service or treatment is experimental or investigational and the Insured Person’s treating Physician certifies in writing that the recommended or requested service or treatment would be significantly less effective if not promptly initiated.

  • Denial of Experimental or Investigational Treatment for Life-Threatening or Seriously Debilitating ConditionsIf a service is denied by Sharp Health Plan or a Plan Medical Group because it is deemed to be an investigational or experimental therapy, you may be entitled to request an IMR of this decision.


More Definitions of Experimental or Investigational Treatment

Experimental or Investigational Treatment means in Our discretion a treatment, drug, device, procedure, supply or service and related services (or any portion thereof, including the form, administration or dosage) for a particular diagnosis or condition when any one of the following exists:
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Experimental or Investigational Treatment means a drug, device, service, or treatment for which:
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Related to Experimental or Investigational Treatment

  • EXPERIMENTAL OR INVESTIGATIONAL means any healthcare service that has progressed to limited human application, but has not been recognized as proven and effective in clinical medicine. See Experimental or Investigational Services in Section 3 for a more detailed description of the type of healthcare services we consider experimental or investigational.

  • Experimental or Investigative means treatments, devices or prescription medications which are recommended by a Physician, but are not considered by the medical community as a whole to be safe and effective for the condition for which the treatments, devices or prescription medications are being used. This includes any treatments, procedures, facilities, equipment, drugs, drug usage, devices, or supplies not recognized as accepted medical practice, and any of those items requiring federal or other governmental agency approval not received at the time services are rendered.

  • Unproven/ Experimental treatment means the treatment including drug experimental therapy which is not based on established medical practice in India.

  • Medical Treatment means examination and treatment by a Legally Qualified Physician for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment.

  • Investigational Product means the Study Drug identified above and the control material, as further detailed in the Protocol;

  • investigating authority means an authority that in terms of national legislation may investigate unlawful activities;

  • Inpatient treatment means twenty-four-hour-per-day mental

  • Life-sustaining treatment means treatment that, based on reasonable medical judgment, sustains the life of a patient and without which the patient will die. The term includes both life-sustaining medications and artificial life support such as mechanical breathing machines, kidney dialysis treatment, and artificially administered nutrition and hydration. The term does not include the administration of pain management medication, the performance of a medical procedure necessary to provide comfort care, or any other medical care provided to alleviate a patient's pain.

  • Mechanical Treatment means the use of power saws, axes, or other approved tools to remove trees.

  • Medically Necessary Treatment means any treatment, tests, medication, or stay in hospital or part of a stay in hospital which:

  • Investigational Medicinal Product means the study drug or control material as defined in the Protocol.

  • Thermal treatment means the treatment of hazardous waste in a device which uses elevated temperatures as the primary means to change the chemical, physical, or biological character or composition of the hazardous waste. Examples of thermal treatment processes are incineration, molten salt, pyrolysis, calcination, wet air oxidation, and microwave discharge. (See also “incinerator” and “open burning”.)

  • clinical investigation means any systematic investigation in one or more human subjects, undertaken to assess the safety or performance of a device;

  • Psychiatric residential treatment facility means a facility which

  • Outpatient treatment means mental health or substance abuse treatment services rendered to a

  • Assisted outpatient treatment or "AOT" means the categories of outpatient services ordered by the court under section 468 or 469a. Assisted outpatient treatment may include a case management plan and case management services to provide care coordination under the supervision of a psychiatrist and developed in accordance with person-centered planning under section 712. Assisted outpatient treatment may also include 1 or more of the following categories of services: medication; periodic blood tests or urinalysis to determine compliance with prescribed medications; individual or group therapy; day or partial day programming activities; vocational, educational, or self-help training or activities; assertive community treatment team services; alcohol or substance use disorder treatment and counseling and periodic tests for the presence of alcohol or illegal drugs for an individual with a history of alcohol abuse or substance use disorder; supervision of living arrangements; and any other services within a local or unified services plan developed under this act that are prescribed to treat the individual's mental illness and to assist the individual in living and functioning in the community or to attempt to prevent a relapse or deterioration that may reasonably be predicted to result in suicide, the need for hospitalization, or serious violent behavior. The medical review and direction included in an assisted outpatient treatment plan shall be provided under the supervision of a psychiatrist.

  • National Treatment NT shall not apply to any measure affecting the type of activities which may be conducted on land or the usage of land, including but not limited to, land zoning, land use and urban planning policies. Urban Redevelopment Authority Act, Chapter 340, 1985 Revised Edition

  • Complaint Investigation means an investigation of any complaint that has been made to a proper authority that is not covered by an abuse investigation.

  • Negligent treatment or maltreatment means an act or a

  • Study means the investigation to be conducted in accordance with the Protocol.

  • Maltreatment means the neglect, abuse, or financial exploitation of a vulnerable adult.

  • Opioid antidote means any drug, regardless of dosage amount or method of administration, which has been approved by the United States Food and Drug Administration (FDA) for the treatment of an opioid overdose. “Opioid antidote” includes, but is not limited to, naloxone hydrochloride, in any dosage amount, which is administered through nasal spray or any other FDA-approved means or methods.

  • Authority or Housing Authority (HA means the Housing Authority.

  • Opioid treatment program means a detoxification or maintenance treatment program which is required to report patient identifying information to the central registry and which is located in the state.

  • Mental or Nervous Disorder means any disease or condition, regardless of whether the cause is organic, that is classified as a Mental or Nervous Disorder in the current edition of International Classification of Diseases, published by the U.S. Department of Health and Human Services, is listed in the current edition of Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association or other relevant State guideline or applicable sources.

  • Day treatment means specialized treatment that is provided to: