Transplant. (BadgerCare Plus and SSI Medicaid Plans) Members who have had a transplant that is considered experimental such as a liver, heart, lung, heart-lung, pancreas, pancreas-kidney or bone marrow transplant are eligible for an exemption.
Transplant procedures not included in the list above, or otherwise excluded under this Contract, such as Experimental or Investigational transplant procedures.
Transplant. (BadgerCare Plus and SSI Medicaid Plans) Members who have had a transplant that is considered experimental such as a liver, heart, lung, heart-lung, pancreas, pancreas-kidney or bone marrow transplant are eligible for an exemption. • Members who have had a transplant that is considered experimental will be permanently exempted from HMO enrollment the first of the month in which surgery is performed. • In the case of autologous bone marrow transplants, the person will be permanently exempted from HMO enrollment the date the bone marrow was extracted. • Members who have had one or more of the transplant surgeries referenced above prior to enrollment in an HMO will be permanently exempted. The effective date will be either the first of the month not more than six months prior to the date of the request, or the first of the month of the HMO enrollment, whichever is later. Exemption requests may be made by the HMO and should be directed to the Department's fiscal agent Nurse Consultant.
Transplant. 2007;7(12):2683-92. References [228] Xxxxxxxxx XX, Xx H, Xxxxxxx C, et al. Use of genetic profiling in leprosy to discriminate clinical forms of the disease. Science 2003;301(5639):1527-30. [229] Xxxxxx DE, Xxxxx N, Xxxxxxx M, et al. Leukocyte immunoglobulin-like receptors: novel innate receptors for human basophil activation and inhibition. Blood 2004;104(9):2832-9. [230] Xxxxx D, Xxxxxxx XX, Xxx XX, Xxxxxxxx K, Xxxxx T, Xxxxxxx XX. Instruction of distinct CD4 T helper cell fates by different notch ligands on antigen-presenting cells. Cell 2004;117(4):515-26. [231] Xxxxxxxx MA, Xxxxxxx R, Xxxx XX, et al. Notch ligand Delta-like 4 regulates disease pathogenesis during respiratory viral infections by modulating Th2 cytokines. X.Xxx.Xxx. 2007;204(12):2925-34.
Transplant. The transplant of human solid organs, specifically: • Heart • Heart/lung • Lung • Double lung • Liver • Pancreas • Kidney • Cornea Transplant also includes: • Bone marrow • Peripheral blood stem cell transplant • CAR-T cell therapy • Transfusion • Re-infusion A transplant occurrence is considered to begin at the point of evaluation for a transplant and end either: • 365 days from the date of the transplant
Transplant. Replacement of solid organs; stem cells; bone marrow or tissue. • Transplant Occurrence. Considered to begin at the point of authorization for evaluation for a Transplant, and end: (1) 365 days from the date of the Transplant; or (2) upon the date the Member is discharged from the Hospital or outpatient facility for the admission or visit(s) related to the Transplant, whichever is later.
Transplant. IRP nurses shall continue to receive on-call pay for all hours worked during assigned on- call. It is not the intent to schedule a Transplant IRP nurse in an on-call status to displace a regular staff nurse’s schedule request. A Transplant IRP nurse who signs up for an on- call shift shall not displace a regular Transplant Coordinator who signs up for the on-call shift. The scheduling of Transplant IRP nurses for on-call is at the discretion of management based on operational needs.
Transplant. Members who have had a stem cell or bone marrow transplant shall have a permanent exemption from HMO enrollment.
Transplant. Solutions (TS) Services • Transplant Network via Centers of Excellence (XXX) • Ventricular Assist Devices (VAD) • Transplant Access Program (TAP) Network • Extra-Contractual Services - contracting on a case-by case basis for transplant care outside of the XXX or TAP Networks for a standard negotiating fee. • Cellular Therapy Services • Specialized Physician Review The fees for Transplant Solutions (TS) Services are specified in Exhibit B – Fees. .
Transplant. Replacement of solid organs; stem cells; bone marrow or tissue. • Transplant Occurrence. Considered to begin at the point of authorization for evaluation for a Transplant, and end: (1) 180 days from the date of the Transplant; or (2) upon the date the Member is discharged from the Hospital or outpatient facility for the admission or visit(s) related to the Transplant, whichever is later. • Urgent Care. Non-preventive or non-routine health care services which are Covered Benefits and are required in order to prevent serious deterioration of a Member’s health following an unforeseen illness, injury or condition if: (a) the Member is temporarily absent from the HMO Service Area and receipt of the health care service cannot be delayed until the Member returns to the HMO Service Area; or, (b) the Member is within the HMO Service Area and receipt of the health care services cannot be delayed until the Member’s Primary Care Physician is reasonably available. AETNA HEALTH INC. 0000 X. XXXXXXX'X GREEN CIRCLE SUITE 310 GREENWOOD VILLAGE, CO 80111 (COLORADO) CERTIFICATE OF COVERAGE AMENDMENT Contract Holder Group Agreement Effective Date: January 1, 2013 The Covered Benefits section of the Certificate is hereby amended to include the following provision: • Basic Infertility Services Benefits. Benefits include only those Infertility services provided to a Member: a) by a Participating Provider to diagnose Infertility; and b) by a Participating Infertility Specialist to surgically treat the underlying medical cause of Infertility. AETNA HEALTH INC. (COLORADO) AMENDMENT TO THE CERTIFICATE OF COVERAGE APPEALS OF ADVERSE BENEFIT DETERMINATIONS Contract Holder Group Agreement Effective Date: January 1, 2013 The HMO Certificate of Coverage is hereby amended as follows: The Appeals of Adverse Benefit Determination provision appearing in the Claim Procedures/Complaints and Appeals section of the Certificate is hereby deleted and replaced by the following:
