Necessary and appropriate definition

Necessary and appropriate means that a strong rational basis exists for concluding that a prerequisite or corequisite is reasonably needed to achieve the purpose that it purports to serve. This standard does not require absolute necessity.
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Necessary and appropriate health services means those health services described in a Medicaid-eligible student’s IEP or IFSP that are:
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Examples of Necessary and appropriate in a sentence

  • Food and Drug Administration (FDA), such equipment or supplies may be covered if determined to be Medically Necessary and appropriate by the treating Physician or Professional Other Provider who issues the written order for the supplies or equipment.

  • In general, contact lenses may be Medically Necessary and appropriate when the use of contact lenses, in lieu of eyeglasses, will result in significantly better visual and/or improved binocular function, including avoidance of diplopia or suppression.

  • Contact lenses may be Medically Necessary and appropriate when the use of contact lenses, in lieu of eyeglasses, will result in significantly better visual and/or improved binocular function, including avoidance of diplopia or suppression.

  • Preauthorization means a determination by HMO that health care services proposed to be provided to a patient are Medically Necessary and appropriate.

  • DefinitionsMedically Necessary Contact Lenses: Contact lenses may be determined to be Medically Necessary and appropriate in the treatment of patients affected by certain conditions.

  • Utilization Management ProgramHNE may review some claims to be sure that they are Covered Services and that they are Medically Necessary and appropriate.

  • UM denials are made only based on whether the treatment or service is covered under your benefit plan, Medically Necessary and appropriate.

  • Benefit details follow each heading.HNE covers the services in this section only if they are Medically Necessary and appropriate.

  • Although a service or supply may be listed as covered, benefits will be provided only if it is Medically Necessary and appropriate in the Member’s particular case.

  • All admissions for Emergency Services are reviewed Retrospectively to determine if the treatment received was Medically Necessary and appropriate.

Related to Necessary and appropriate

  • Appropriate means the treatment's timing and setting are proper and cost effective. Medical treatments which are not proven, effective and appropriate are not covered by the Plan.

  • Necessary preconstruction approvals or permits means those permits or approvals required under federal air quality control laws and regulations and those air quality control laws and regulations which are part of the applicable State Implementation Plan.

  • Governmental Approvals means all authorizations, consents, approvals, permits, licenses and exemptions of, registrations and filings with, and reports to, all Governmental Authorities.

  • Reasonable Efforts means, with respect to any action required to be made, attempted, or taken by an Interconnection Party or by a Construction Party under Tariff, Part IV or Tariff, Part VI, an Interconnection Service Agreement, or a Construction Service Agreement, such efforts as are timely and consistent with Good Utility Practice and with efforts that such party would undertake for the protection of its own interests. Regional Entity:

  • Reasonable suspicion means a basis for forming a belief based on specific facts and rational inferences drawn from those facts.

  • Permits means all permits, licenses, registrations, certificates, orders, approvals, authorizations, consents, waivers, franchises, variances and similar rights issued by or obtained from any Governmental Authority.