NQTL definition

NQTL means non-quantitative treatment limitation, and includes but is not limited to preauthorization requirements and first-fail requirements.
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NQTL means Non-quantitative treatment limitation.
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NQTL means a nonquantitative treatment limitation as defined in Insurance Article, §15-144(a)(6), Annotated Code of Maryland.
Sample 1

Examples of NQTL in a sentence

  • While operational outcomes are not determinative of NQTL compliance, and an insurer may comply with the NQTL requirement notwithstanding a disparate outcome for an NQTL applied to MH/SUD benefits as compared to M/S benefits, comparable outcomes can help evidence compliance with the in-operation component of the NQTL requirement.

  • Consequently, Cigna concludes that the NQTL was applied comparably and no more stringently to MH/SUD benefits than to M/S benefits.

  • While operational outcomes are not determinative of NQTL compliance, and a plan may comply with the NQTL requirement notwithstanding a disparate outcome for an NQTL applied to MH/SUD benefits as compared to M/S benefits, comparable outcomes can help evidence compliance with the in-operation component of the NQTL requirement.

  • In the context of NQTL compliance, the inclusion of a physician with appropriate MH/SUD treatment expertise on the clinical P&T Committee that assigns clinical designations to M/S and MH/SUD drugs evidences the comparability of the process by which formulary management decisions are made, in writing and in operation, across M/S and MH/SUD prescription drug benefits.

  • Consistency in standards and process evidences compliance with the NQTL requirement.

  • Consequently, case management does not function as an NQTL under the cited parity requirement.

  • Notwithstanding the inapplicability of the NQTL requirement to Cigna's voluntary case management program, Cigna offers case management services to enrollees with either complex MH/SUD or M/S conditions.

  • That is, Cigna does not apply a utilization management requirement to an MH/SUD drug that does not exhibit the factors/standards described in the preceding columns that, as-written, justify application of a utilization management requirement to a drug, and in terms of stringency of application of the NQTL no M/S drugs are omitted from a utilization management requirement if they exhibit the same factors/standards.

  • Provide the specific plan language for each NQTL in the above defined category and identify the medical/surgical and mental health and/or substance use disorder benefits to which it applies; Medical/Surgical Benefits (M/S)Mental Health/Substance Use Disorder Benefits (MH/SUD)Case ManagementCase Management is a service provided through a Review Organization, which assists individuals with treatment needs that extend beyond the acute care setting.

  • In summary, the comparative analyses documented in the narratives to Steps 4 and 5, which themselves construe the application of the multi-tiered formulary design NQTL described in Steps 1 through 3, demonstrate the compliance in-writing and in-operation of the quantity limit/prior authorization NQTL.


More Definitions of NQTL

NQTL means a non-quantitative treatment limitation as defined in Insurance Article, § 15-144(a)(6), Annotated Code of Maryland.
Sample 1

Related to NQTL

  • Share Option Plan means any equity incentive plan of the General Partner, the General Partner Entity, the Partnership and/or any Affiliate of the Partnership.

  • Stock Option Plan means any stock option plan now or hereafter adopted by the Company or by the Corporation, including the Corporate Incentive Award Plan.

  • Share Option Scheme ’ means the share option scheme adopted by the Company on

  • Option Style “Modified American”, as described under “Procedures for Exercise” below Option Type: Call Buyer: Counterparty Seller: Dealer

  • Work Order means an individually negotiated document that is executed by both Parties and which authorizes a Project, if any, in an indefinite quantity Contract.

  • Employee Stock Purchase Plan means a plan that grants Purchase Rights intended to be options issued under an “employee stock purchase plan,” as that term is defined in Section 423(b) of the Code.

  • Stock Purchase Plan means the employee stock purchase plan to be established by Water Pik pursuant to Section 2.2.

  • Rectification Plan means the rectification plan pursuant to the Rectification Plan Process;

  • Plan 2 means the teachers' retirement system, plan 2

  • Stock Option Plans means any stock option plan now or hereafter adopted by the Partnership or the General Partner.

  • Full Notice to Proceed means that all material third party contractors have been given the notice to proceed with construction by the Capacity Market Seller or its agent, with a guaranteed completion date backed by liquidated damages.

  • Share Option means a Nonqualified Share Option or an Incentive Share Option.

  • Flexi Plan means any individual indemnity hospital insurance plan under the VHIS framework with enhancement(s) to any or all of the protections or terms and benefits that the Standard Plan provides to the Policy Holder and the Insured Person, subject to certification by the Government. Such plan shall not contain terms and benefits which are less favourable than those in the Standard Plan, save for the exception as may be approved by the Government from time to time.

  • Option 3 [ ] A Participant satisfies the Plan's Early Retirement Age conditions by attaining age ________ (not less than 55) and completing ________ Years of Vesting Service.

  • IITK Purchase Order means the IITK’s official Purchase Order document;

  • Stock Reload Option means any option granted under Section 6.3, below, as a result of the payment of the exercise price of a Stock Option and/or the withholding tax related thereto in the form of Stock owned by the Holder or the withholding of Stock by the Company.

  • Notice of Stock Option Grant means the document so entitled to which this Agreement is attached.

  • Stop Work Order means the written Notice, delivered in accordance with this Agreement, by which the State may require the Contractor to stop all, or any part, of the Work of this Agreement, for the period set forth in the Stop Work Order. The Stop Work Order shall be specifically identified as such and shall indicate that it is issued pursuant to the Stop Work provision in this Exhibit B.

  • Mining Plan means a mining plan drawn in accordance with clause (b) of sub-section

  • Urban renewal plan means a plan, as it exists from time to time, for an urban renewal project, which plan shall be sufficiently complete to indicate such land acquisition, demolition and removal of structures, redevelopment, improvements, and rehabilitation as may be proposed to be carried out in the urban renewal area, zoning and planning changes, if any, land uses, maximum density and building requirements.

  • Programme of work means the Programme of work submitted by the contractor and approved by the Engineer-in-charge and includes and amendment thereto made from time to time and approved by the Engineer-in-charge;

  • Stock Option Agreement means the agreement between the Company and an Optionee that contains the terms, conditions and restrictions pertaining to the Optionee’s Option.

  • BCDR Plan means the plan consisting of general business continuity and disaster recovery principles, the Business Continuity Plan and Disaster Recovery Plan as further described in paragraph 1.2 of Schedule 2- 14.

  • Notice to Proceed means notice issued by the OPWC pursuant to Section IV of this Agreement. "OPWC" means the Ohio Public Works Commission created pursuant to Revised Code Section 164.02.

  • Indigenous Peoples Plan or “IPP” means any of the plans prepared and carried out following the requirements of the Indigenous Peoples Planning Framework.

  • Company Stock Option Plan means each stock option plan, stock award plan, stock appreciation right plan, phantom stock plan, stock option, other equity or equity-based compensation plan, equity or other equity based award to any employee, whether payable in cash, shares or otherwise (to the extent not issued pursuant to any of the foregoing plans), or other plan or contract of any nature with any employee pursuant to which any stock, option, warrant or other right to purchase or acquire capital stock of the Company or right to payment based on the value of Company capital stock has been granted or otherwise issued.