Medically Necessary definition
Examples of Medically Necessary in a sentence
Medically Necessary or Medical Necessity means Medically Necessary Service as defined by Utah Administrative Code R414-1-2.
In accordance with 42 CFR 422.208, the Contractor may operate a Physician Incentive Plan only if the Contractor makes no specific payment, directly or indirectly, to a physician or physician group as an inducement to reduce or limit Medically Necessary Covered Services furnished to any particular Enrollee.
Services required to stabilize an Enrollee includes all emergency services that are Medically Necessary to assure, within reasonable medical probability, that no material deterioration of the Enrollee’s condition is likely to result from, or occur during, discharge of the Enrollee or transfer of the Enrollee to another facility.