Poststabilization Care Services, Generally Clause Samples
The "Poststabilization Care Services, Generally" clause defines the obligations and procedures for providing medical care to patients after their condition has been stabilized in an emergency setting. Typically, this clause outlines the types of services that must be offered, the process for obtaining authorization for continued care, and the responsibilities of healthcare providers and payers during this phase. For example, it may specify when a provider can proceed with further treatment or when they must seek approval from an insurer. The core function of this clause is to ensure that patients receive necessary ongoing care after stabilization while clarifying the administrative steps and financial responsibilities involved, thereby preventing gaps in treatment and disputes over coverage.
Poststabilization Care Services, Generally. The Contractor shall cover and pay for Poststabilization Care Services in accordance with the guidelines found in 42 CFR § 422.113(c). Generally, Poststabilization Care Services begin when an Enrollee is admitted for inpatient hospital psychiatric services after the Enrollee has received Emergency Services or other inpatient services.