Accepted standards of medical practice definition

Accepted standards of medical practice means the standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, physician specialty society recommendations, and/or the view of physicians practicing in relevant clinical areas and any other relevant factors. Reasonable and medically necessary prescription drug coverage determination decisions made by WellPoint will consider both “approved” (FDA approved and labeled) and “unlabeled” (clinical uses and indications that do not have official FDA approval) drug and biological uses, (currently defined and guided by in Chapter 15, Section 50.4.1, 50.4.2, 50.4.5 of the Medicare Benefit Policy Manual); or so modified by CMS. When WellPoint elects to create its own formularies, formulary exceptions, and utilization management criteria (considered non-standard by PBM), PBM will, subject to Section 2.5 of the Agreement, administer per the criteria established by WellPoint. The PBM will ensure that, subject to Section 2.5 of the Agreement, all WellPoint criteria are loaded to its system and that all applicable PBM staff will be trained in a timely manner consistent with the remaining terms of this Agreement. In all instances the reasonableness, medical necessity, and CMS compliance of the established [*] Redacted text. Confidential treatment requested; omitted text filed separately with the Securities and Exchange Commission. 102 criteria will be the sole responsibility of WellPoint. PBM does not and will not make medical necessity determinations hereunder, but rather administers the Plans’ pharmacy benefits pursuant to WellPoint adopted plan designs and formulary(ies).
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Examples of Accepted standards of medical practice in a sentence

  • Accepted standards of medical practice discouraged the use of opioids to treat chronic pain due to a lack of evidence that opioids improved function and were effective for everyday pain management.

  • The review must be consistent with: • Accepted standards of medical practice; • EMTALA statutory definitions; • Evidence-based clinical standards; and • Sound clinical judgment.

  • Accepted standards of medical practice must be upheld regardless of means of communication or delivery of health care services.

  • Randomized, open-label phase II study evaluating the efficacy and safety of talimogene laherparepvec in combination with ipilimumabversus ipilimumab alone in patients with advanced, unresectable melanoma.

Related to Accepted standards of medical practice

  • Generally accepted standards of medical practice means standards that are based upon: credible scientific evidence published in peer-reviewed medical literature and generally recognized by the relevant medical community; physician and health care provider specialty society recommendations; the views of physicians and health care providers practicing in relevant clinical areas and any other relevant factor as determined by statute(s) and/or regulation(s).

  • standards of generally recognised accounting practice means an accounting practice complying with standards applicable to municipalities or municipal entities as determined by the Accounting Standards Board

  • Practice of medicine means the clinical prevention, diagnosis, or treatment of human disease, injury, or condition requiring a physician to obtain and maintain a license in compliance with the medical practice act of a member state.

  • Practice of medicine or osteopathic medicine means the prevention, diagnosis and treatment of

  • Standards of Practice means the care, skill, and

  • Clinical practice guidelines means a systematically developed statement to assist

  • Good Clinical Practices means the FDA’s standards for the design, conduct, performance, monitoring, auditing, recording, analysis, and reporting of clinical trials contained in 21 C.F.R. Part 50, 54, 56, 312, 314, 320, 812, and 814 and (ii) “Good Laboratory Practices” means the FDA’s standards for conducting non-clinical laboratory studies contained in 21 C.F.R. Part 58.

  • Good Clinical Practice or “GCP” means the then current standards for clinical trials for pharmaceuticals, as set forth in the ICH guidelines and applicable regulations promulgated thereunder, as amended from time to time, and such standards of good clinical practice as are required by the European Union and other organizations and governmental agencies in countries in which a Licensed Product is intended to be sold to the extent such standards are not less stringent than the ICH guidelines.

  • Uniform Standards of Professional Appraisal Practice means the current standards of the appraisal profession, developed for appraisers and users of appraisal services by the Appraisal Standards Board of the Appraisal Foundation.

  • Medical practice act means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state.

  • Air Standards Manager means the Manager, Human Toxicology and Air Standards Section, Standards Development Branch, or any other person who represents and carries out the duties of the Manager, Human Toxicology and Air Standards Section, Standards Development Branch, as those duties relate to the conditions of this Certificate.

  • Hospital practice protocol means a written plan, policy, procedure, or agreement that authorizes drug therapy management between hospital pharmacists and physicians within a hospital and the hospital’s clinics as developed and determined by the hospital’s P&T committee. Such a protocol may apply to all pharmacists and physicians at a hospital or the hospital’s clinics or only to those pharmacists and physicians who are specifically recognized. A hospital practice protocol shall comply with the requirements of subrule 8.34(3).

  • Qualified Medical Practitioner means any person legally authorized by the Government with jurisdiction in the geographical area of his or her practice to render medical or surgical service, but excluding a qualified medical practitioner who is the Insured Person or an Immediate Family Member of the Insured Person.

  • Good Industry Practice means standards, practices, methods and procedures conforming to the Law and the degree of skill and care, diligence, prudence and foresight which would reasonably and ordinarily be expected from a skilled and experienced person or body engaged in a similar type of undertaking under the same or similar circumstances.

  • registered medical practitioner means a medical practitioner registered under the Medical Act 1971 [Act 50];

  • Community practice protocol means a written, executed agreement entered into voluntarily between an authorized pharmacist and a physician establishing drug therapy management for one or more of the pharmacist’s and physician’s patients residing in a community setting. A community practice protocol shall comply with the requirements of subrule 8.34(2).

  • Practice of radiologic technology means the application of x-rays to human beings for diagnostic or

  • general medical practitioner means a general practitioner as defined in section 3 of the Health Insurance Act 1973.

  • Practice of pharmacy means providing pharmacist care requiring specialized knowledge, judgment, and skill derived from the principles of biological, chemical, behavioral, social, pharmaceutical, and clinical sciences. As used in this division, "pharmacist care" includes the following:

  • Standards of Apprenticeship means this entire document, including these definitions.

  • medical practitioner means a person who holds a valid registration from the Medical Council of any State or Medical Council of India or Council for Indian Medicine or for Homeopathy set up by the Government of India or a State Government and is thereby entitled to practice medicine within its jurisdiction; and is acting within its scope and jurisdiction of license. The registered practitioner should not be the insured or close Family members.

  • Good Industry Practices means the practices that would be adopted by, and the exercise of that degree of care, skill, diligence, prudence and foresight that reasonably would be expected from, a competent contractor in the international oil and gas industry experienced in performing work similar in nature, size, scope and complexity to the Work and under conditions comparable to those applicable to the Work, where such work is subject to, and such contractor is seeking to comply with, the standards and codes specified in the Contract or (to the extent that they are not so specified) such national or international standards and codes as are most applicable in the circumstances, and the applicable Law.

  • Good Manufacturing Practices means current good manufacturing practices, as set forth in 21 C.F.R. Parts 210 and 211.

  • Specialist medical practitioner means a specialist as defined in section 3 of the Health Insurance Act 1973.

  • Current Good Manufacturing Practices or “cGMP” means applicable Good Manufacturing Practices as specified in the United States Code of Federal Regulations and/or the EU Good Manufacturing Guidelines, and any successor legislation from time to time, prevailing at the time of the manufacture of the Product.

  • Unethical practice means any activity on the part of bidder, which try to circumvent tender process in any way. Unsolicited offering of discounts, reduction in financial bid amount, upward revision of quality of goods etc after opening of first bid will be treated as unethical practice.