Medically necessary health care definition

Medically necessary health care means health care services or products provided to an enrollee for the purpose of preventing, diagnosing or treating an illness, injury or disease or the symptoms of an illness, injury or disease in a manner that is:
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Examples of Medically necessary health care in a sentence

  • Medically necessary health care services, including equipment and supplies, that are prescribed by your provider for the management and treatment of type I diabetes, type II diabetes, and/or gestational diabetes.

  • Habilitative Services Medically necessary health care services that help a covered person keep, learn or improve skills and functioning for daily living.

  • Medically necessary definition Medically necessary health care services or supplies are medically appropriate and:• Necessary to meet members’ basic health needs.• Cost-efficient and appropriate for the covered services.

  • Medically necessary health care services that are identified under the EPSDT program for eligible children, and that are within the scope of mandatory or optional services under Federal law, must be covered even if those services are not included as part of the covered services in that State’s Plan; and (2) States may request waivers to pay for otherwise uncovered home and community-based services (HCBS) for Medicaid-eligible persons who might otherwise be institutionalized.

  • Representatives Lima, Ehrhardt, Caprio, Corvese, San Bento and Gemma discuss the act.

  • Medically necessary health care must continue to be provided throughout the referral process, and regardless of whether or the child is accepted into the CCS program.6 The PCP and the Member’s IPA are responsible for all medically necessary health care related to a potential CCS eligible condition until CCS establishes eligibility and issues a Service Authorization Request (SAR).7 The IPA will be reimbursed should CCS determine upon later review that the Member qualified for the program.

  • Medically necessary health care, including diagnostic services and treatment, which are reimbursable pursuant to 42 U.S.C. § 1396d, and which are not otherwise reimburs- able under the Wyoming Medicaid State Plan.

  • Medically necessary health care services or supplies are medically appropriate and:• Necessary to meet members’ basic health needs.• Cost-efficient and appropriate for the covered Assignment to UnitedHealthcare Community PlanMAXIMUS, Texas HHSC’s enrollment broker, assists Medicaid members in choosing an MCO and a PCP from the contracted health plans in Texas and their associated care provider networks.

  • It also noted that the status of breadwinner is given by the religious courts in accordance with Islamic law and traditions governing Jordanian society.

  • Medically necessary definition Medically necessary health care services or supplies are medically appropriate and:• Necessary to meet individuals’ basic health needs.• Cost-efficient and appropriate for the covered services.

Related to Medically necessary health care

  • Medically Necessary means a service which is appropriate and consistent with the treatment of the condition in accordance with accepted standards of community practice.

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Health care practitioner means an individual licensed

  • Medically fragile means the condition of a child who requires the availability of twenty-four-hour skilled care from a health care professional or specially trained staff or volunteers in a group care setting. These conditions may be present all the time or frequently occurring. If the technology, support and services being received by the medically fragile children are interrupted or denied, the child may, without immediate health care intervention, experience death.

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Health care professional means a physician or other health care practitioner licensed, accredited or certified to perform specified health care services consistent with state law.