Common use of Continuing Services Clause in Contracts

Continuing Services. Covered Services that were previously authorized by the Contractor and are the subject of an internal Appeal or Board of Hearings (BOH) Appeal, if applicable, involving a decision by the Contractor to terminate, suspend, or reduce the previous authorization and which are provided by the Contractor pending the resolution of the internal Appeal or BOH Appeal, if applicable. Continuing Services (also referred to as continuation of benefits per §422.632) include previously approved Medicare and/or Medicaid benefit(s) that the plan is terminating, suspending, or reducing.

Continuing Services. Covered Services that were previously authorized by the Contractor and are the subject of an internal Appeal or Board of Hearings (BOH) Appeal, if applicable, involving a decision by the Contractor to terminate, suspend, or reduce the previous authorization and which are provided by the Contractor pending the resolution of the internal Appeal or BOH Appeal, if applicable. Continuing Services In the event of the adverse integrated organization determination, the Enrollee must request to continue services (also referred to as continuation of benefits per §422.632) include for the previously approved Medicare and/or Medicaid benefit(s) that the plan is terminating, suspending, or reducing.