Healthcare Services. (a) The MA Dual SNP must provide the MA Product to all Dual Eligible Members and Other Dual SNP Members who are qualified to receive such services under the terms of the MA Agreement.
Healthcare Services. (a)The MA Health Plan must provide the MA Product to all Dual Eligible Members who are qualified to receive such services under the terms of the MA Agreement. The MA Health Plan must pay all eligible Network Providers and out-of-network providers the Cost Sharing Obligations incurred on behalf of Dual Eligible Members. Except as provided in Section 3.03(b), the amount or method of payment for Cost Sharing Obligations included in the agreements with Network Providers or out-of-network providers may differ between agreements.
Healthcare Services. All Inpatient and non-routine Outpatient non-Emergency Mental Health, Severe Mental Illness, and Substance Related and Addictive Disorder Services, including: o Intensive outpatient program treatment. o Outpatient electro-convulsive treatment. o Psychological testing. • All Specialist visits or consultations. • Prosthetic Devices, Orthotic Devices and Durable Medical Equipment. • Allergy testing or treatment (e.g., skin, RAST); angioplasty; physiotherapy or Manual Manipulation and; habilitative and rehabilitation therapy (physical, speech, occupational).
Healthcare Services. 23.1.1 The Concessionaire agrees and undertakes that the District Hospital shall provide the Healthcare Services, in accordance with the provisions of this Agreement, Applicable Laws, Applicable Permits, Good Healthcare Practice and Good Clinical Practice and Good Industry Practice.
Healthcare Services. The term "Healthcare Services" shall mean the medical and related healthcare services provided by Physician to patients.
Healthcare Services. (a) Both Parties recognise the need to upgrade and modernise the health sector through investment in health infrastructure, promotion of healthcare services, access to technologies, developing human resources, encouraging medical tourism, sharing of knowledge on Research and Development in the field of medicine and health.
Healthcare Services. The Subcontractor shall ensure adequate access to the services provided under this Contract in accordance with the prevailing medical community standards. The services covered by this Contract must be in accordance with the South Carolina State Plan for Medical Assistance under Title XIX of the Social Security Act, and the Subcontractor shall provide these services to Medicaid Managed Care Members through the last day that this Contract is in effect. All final Medicaid benefit determinations are within the sole and exclusive authority of the Department or its designee. The Subcontractor may not refuse to provide Medically Necessary Services or covered preventive services to Medicaid Managed Care Members for non-medical reasons. The Subcontractor shall render Emergency Services without the requirement of prior authorization of any kind. The Subcontractor shall not be prohibited or otherwise restricted from advising a Medicaid Managed Care Member about the health status of the Medicaid Managed Care Member or medical care or treatment for the Medicaid Managed Care Member’s condition or disease, regardless of whether benefits for such care or treatment are provided under the Department’s Medicaid Managed Care Contract, if Provider is acting within the lawful scope of practice. The CONTRACTOR shall not include covenant-not-to-compete requirements or exclusive Provider clauses in its Provider agreements. Specifically, the CONTRACTOR is precluded from requiring that the Provider not provide services for any other South Carolina Medicaid Managed Care CONTRACTOR. In addition, the CONTRACTOR shall not enter into Subcontracts that contain compensation terms that discourage Providers from serving any specific eligibility category. No provision in this Subcontract shall create a covenant-not-to-compete agreement or exclusive Provider clause. The Subcontractor must take adequate steps to ensure that Medicaid Managed Care Members with limited English skills receive, free of charge, the language assistance necessary to afford them meaningful and equal access to the benefits and services provided under this Contract in accordance with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et. seq.) (2001, as amended) and it’s implementing regulation at 45 C.F.R. Part 80 (2001, as amended). The Subcontractor shall provide effective Continuity of Care activities, if applicable, that seek to ensure that the appropriate personnel, including the PCP are kept informed of the ...
Healthcare Services. On [●], our Company entered into a healthcare services framework agreement (the “Healthcare Services Framework Agreement”) with Redco Properties, for a term commencing from the [REDACTED] to December 31, 2023, which may be renewed as the parties may mutually agree, subject to compliance with the requirements under Chapter 14A of the Listing Rules and all other applicable laws and regulations. Pursuant to the Healthcare Services Framework Agreement, Redco Properties agreed to procure from us, and we agreed to provide, healthcare services to the owners, occupants or residents of certain residential properties developed by Redco Properties and its subsidiaries, including but not limited to healthcare consultancy, nutrition and elderly care service, health assessment and health management services (“Healthcare Services”). Due to certain home purchase offers made by Redco Group to its property purchaser customers, the Healthcare Services fees required to be paid by the relevant owners, occupants or residents to us for use of the Healthcare Services will be settled or reduced by way of reductions or reliefs, gifts or other marketing offers for the relevant service users, and instead be paid by Redco Group to us. Such settlement and reduction will be fully pre-paid to us by Redco Properties or its subsidiaries before we provide the Healthcare Services to the relevant service users pursuant to the Healthcare Services Framework Agreement. As the Healthcare Services Framework Agreement is a framework agreement, relevant subsidiaries of Redco Properties and relevant members of our Group will enter into separate agreements which will set out the specific terms and conditions according to the principle terms provided in the Healthcare Services Framework Agreement. Historical transaction amounts During the Track Record Period, there was no historical transaction amount for our Group, as the companies of our Group now engaged in the provision of the healthcare services were acquired from TGI and were only included in the financial statements of the Group from the date of the acquisition of their offshore holding company which was December 30, 2020, based on the acquisition method of accounting which is used to account for business combinations our Group. Annual caps Our Directors estimate that the annual service fees in relation to the Healthcare Services to be paid under the Healthcare Services Framework Agreement for each of the years ending December 31, 2021, 2022 and...
Healthcare Services. If you are admitted as an Inpatient to the Hospital, you or your Practitioner needs to notify us as soon as possible so we can review your Hospital stay. We will not deny a claim for Emergency Health services when the Member was referred to the emergency room by his or her PCP or by our representative. If your Emergency Health services results in a hospitalization directly from the emergency room, you are responsible for paying the Inpatient Hospital Cost Sharing amounts (Deductible, Coinsurance and/or Copayment) rather than the emergency room visit Copayment. Refer to your Summary of Benefits and Coverage for the required Cost Sharing. For Emergency Healthcare Services received Out-of-network and/or outside of New Mexico (our Service Area), you may seek Emergency Healthcare Services from the nearest appropriate facility where Emergency Healthcare Services can be rendered. Non-emergent follow-up care received outside of New Mexico is not Covered unless transfer to an In-network Practitioner/Provider would be medically inappropriate and a risk to your health. In such circumstances, we must Authorize the Healthcare Services. Non-emergent follow-up care outside of New Mexico is not Covered for your convenience or preference. You are responsible for any such charges that we do not Authorize. Follow-up care from an Out-of-network Practitioner/Provider requires our Prior Authorization.
Healthcare Services. Specialised Medical Services (CPC 93122) covering forensic medicine, nuclear medicine, geriatrics, micro vascular surgery, neurosurgery, cardiothoracic surgery, plastic surgery, clinical immunology and oncology, traumatology, anaesthesiology, intensive care specialist, child psychiatry, and physical medicine Unbound except as indicated under this Horizontal Section. - Practice only in private hospitals of at least 50 beds; - Practice to be only at a specified location and a change of location requires approval; and - The setting up of individual or joint group practices is not permitted.
