Medically Necessary Requirements Sample Clauses

Medically Necessary Requirements. The CONTRACTOR must ensure that the payment and health care coverage policies for the Network Providers include this requirement, and have an approved definition ofMedically Necessary” in the CONTRACTOR’s provider manuals and handbooks, consistent with Section 4 and Appendix A of this Contract.
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Medically Necessary Requirements a. The CHC-MCO must describe the process to validate medical necessity for:  covered care and services;  procedures and level of care;  medical or therapeutic items.

Related to Medically Necessary Requirements

  • Medically Necessary In general, We will not Cover any dental service, procedure, treatment, test or device that We determine is not Medically Necessary. If an External Appeal Agent certified by the State overturns Our denial, however, We will Cover the service, procedure, treatment, test or device for which coverage has been denied, to the extent that such service, procedure, treatment, test or device, is otherwise Covered under the terms of this Contract.

  • Medically Necessary Services for the State plan services in Addendum VIII. B medically necessary has the meaning in Wis. Admin. Code DHS §101.03(96m): services (as defined under Wis. Stat. § 49.46

  • HIPAA Requirements The Parties agree that the provisions under HIPAA Rules that are required by law to be incorporated into this Amendment are hereby incorporated into this Agreement.

  • E-Verify Requirements To the extent applicable under ARIZ. REV. STAT. § 41- 4401, the Contractor and its subcontractors warrant compliance with all federal immigration laws and regulations that relate to their employees and their compliance with the E-verify requirements under ARIZ. REV. STAT. § 23-214(A). Contractor’s or its subcontractor’s failure to comply with such warranty shall be deemed a material breach of this Agreement and may result in the termination of this Agreement by the City.

  • Health Requirements This is an active trip that requires you to make a realistic assessment of your health. To enjoy the trips as intended, a minimum level of fitness is required. All Participants are expected to be in active good health, to be comfortable traveling as part of a group, and to be ready to experience cultural differences with grace. Air Journey will require prior notice if any participant has any physical or other condition or disability that would prevent them from participating in active elements of any trip and/or could create a hazard to him or herself or to other members of the group. Air Journey may require guests to produce a doctor’s certificate certifying that they are fit to participate. Any physical condition requiring special attention, diet, or treatment should be reported in writing when the reservation is made. We will make reasonable efforts to accommodate Participants with special needs; however, we cannot accommodate wheelchairs. . Walking and climbing stairs are required in many hotels and airports, and are part of many excursions. If you require a slower pace, extra assistance, or the use of a cane or walking stick, arrangements will be made for private touring at each destination, if necessary, at the discretion of our Journey staff. Any extra cost for such arrangements will be the responsibility of the Participant. If you would like to forego some of the scheduled sightseeing to rejuvenate and relax, please feel free to do so at any time. Acting reasonably, if Air Journey is unable to properly accommodate the need of the person(s) concerned or believes that health and safety may be compromised, Air Journey reserves the right to refuse participation. Air Journey also reserves the right to remove from the trip, at the participant’s own expense, anyone whose physical condition or conduct negatively impacts the enjoyment of the other guests or disrupts the tour. Malaria and other diseases may be present in some of the countries featured in this itinerary; proof of yellow fever inoculation may be required. For the latest recommendations on specific health precautions for the areas you will visit, consult your physician and the Centers for Disease Control. The participant represents that neither he nor she nor anyone traveling with him or her has any physical or other condition or disability that could create a hazard to himself or herself or other members of the tour. Itinerary Changes The itinerary and Journey leaders are subject to modification and change by Air Journey. Every reasonable effort will be made to operate the Journey as planned; however, should unforeseen world events and conditions require our itinerary to be altered, Air Journey reserves the right to do so for the safety and best interest of the group without prior notification or consultation. The operation of these flights is subject to the foreign governments involved granting landing rights for the flight. If the air carrier cannot obtain these rights for any particular flight leg of the Journey, that flight leg will be canceled and alternative arrangements may be made, at the discretion of Air Journey. Every effort will be made to operate tours as planned but alterations may occur after the final itinerary has been issued.

  • Accessibility Requirements Under Tex. Gov’t Code Chapter 2054, Subchapter M, and implementing rules of the Texas Department of Information Resources, the System Agency must procure Products and services that comply with the Accessibility Standards when those Products are available in the commercial marketplace or when those Products are developed in response to a procurement solicitation. Accordingly, Grantee must provide electronic and information resources and associated Product documentation and technical support that comply with the Accessibility Standards.

  • Match Requirements There is no match required on the part of the Grantee under this Agreement.

  • Staff Requirements Contractor shall employ, at a minimum, the following:

  • Regulatory Requirements Each Party’s obligations under this Agreement shall be subject to its receipt of any required approval or certificate from one or more Governmental Authorities in the form and substance satisfactory to the applying Party, or the Party making any required filings with, or providing notice to, such Governmental Authorities, and the expiration of any time period associated therewith. Each Party shall in good faith seek and use its Reasonable Efforts to obtain such other approvals. Nothing in this Agreement shall require Developer to take any action that could result in its inability to obtain, or its loss of, status or exemption under the Federal Power Act or the Public Utility Holding Company Act of 2005 or the Public Utility Regulatory Policies Act of 1978, as amended.

  • Statutory Requirements All statutory requirements for the valid consummation by the Company of the transactions contemplated by this Agreement shall have been fulfilled. All authorizations, consents and approvals of all governments and other persons required to be obtained in order to permit consummation by the Company of the transactions contemplated by this Agreement shall have been obtained.

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