Examples of Necessity in a sentence
The determination of Medical Necessity shall be made on a case-by-case basis and in accordance with the definition of Medical Necessity defined by the Department and regulations.
Provider and its Contracted Providers shall render Covered Services in accordance with Medical Necessity as defined in the State Contract.
Health Insurance; Home and Community-Based Services; Hospice Services; Hospital Outpatient Care; Medical Necessity; Non-Participating Provider; Plan; Premium; Primary Care Provider; Prior Authorization; Provider; Provider Network; Single Preferred Drug List (sPDL); Special Health Care Needs; Specialist; and Urgent Care as required in 42 CFR § 438.10(c)(4)(i).
It does not include a Claim from a provider who is under investigation for Fraud, Waste or Abuse, or a Claim under review for Medical Necessity.