Restricted Enrollees. If MVP determines that you have received contraindicated, excessive or duplicative pharmacy services, MVP may impose one or more of the following restrictions on the provision of benefits to you under your Contract:
Restricted Enrollees Sample Clauses
Related to Restricted Enrollees
LEAST RESTRICTIVE ENVIRONMENT/DUAL ENROLLMENT CONTRACTOR and XXX shall follow all LEA policies and procedures that support Least Restrictive Environment (“LRE”) options and/or Dual Enrollment options for students to have access to the general curriculum and to be educated with their nondisabled peers to the maximum extent appropriate. CONTRACTOR shall ensure that LRE placement options are addressed at all IEP team meetings regarding students for whom ISAs have been or may be executed. This shall include IEP team consideration of supplementary aids and services, goals and objectives necessary for placement in the LRE and necessary to enable students to transition to less restrictive settings. When an IEP team has determined that a student should be transitioned into the public school setting, CONTRACTOR shall assist the LEA in implementing the IEP team’s recommendations activities to support the transition.
Restricted Employment for Certain State Personnel Contractor acknowledges that, pursuant to Section 572.069 of the Texas Government Code, a former state officer or employee of a state agency who during the period of state service or employment participated on behalf of a state agency in a procurement or contract negotiation involving Contractor may not accept employment from Contractor before the second anniversary of the date the Contract is signed or the procurement is terminated or withdrawn.
Medically Necessary Services for the State plan services in Addendum VIII. B medically necessary has the meaning in Wis. Admin. Code DHS §101.03(96m): services (as defined under Wis. Stat. § 49.46
DEPENDENT PERSONAL SERVICES 1. Subject to the provisions of Articles 16, 18 and 19, salaries, wages and other similar remuneration derived by a resident of a Contracting State in respect of an employment shall be taxable only in that State unless the employment is exercised in the other Contracting State. If the employment is so exercised, such remuneration as is derived therefrom may be taxed in that other State.
Least Restrictive Environment The Board and the Association acknowledge that the policy of least restrictive environment is legally mandated and intended in the best educational interest of the student. Accordingly, the parties who would fit legal requirements which would involve the use of an Individual Educational Planning Team (IEPT) for placement in the regular classroom must be appropriate to the student’s unique needs as determined by an IEP on an individual basis. For the purpose of this section, such students shall be referred to as “mainstreamed students.”
Health Plan An appropriately licensed entity that has entered into a contract with Subcontractor, either directly or indirectly, under which Subcontractor provides certain administrative services for Health Plan pursuant to the State Contract. For purposes of this Appendix, Health Plan refers to UnitedHealthcare Insurance Company.
Employee and Family Assistance Plan The CODC PRO Care Plan is an industry-funded employee and family assistance plan for employees and their eligible family members according to the participation of sponsoring organizations and employers as well as Plan eligibility rules. Employees must be enrolled in the Plan by their employer to become eligible for Plan benefits, subject to the Plan eligibility rules. An individual employee cannot self-enroll in the Plan. Remittances and Reports
Community Based Adult Intensive Service (AIS) and Child and Family Intensive Treatment (CFIT) – AIS/CFIT programs offer services primarily based in the home and community for qualifying adults and children with moderate- to-severe mental health conditions. These programs consist at a minimum of ongoing emergency/crisis evaluations, psychiatric assessment, medication evaluation and management, case management, psychiatric nursing services, and individual, group, and family therapy. In a Provider’s Office/In Your Home This plan covers individual psychotherapy, group psychotherapy, and family therapy when rendered by: • Psychiatrists; • Licensed Clinical Psychologists; • Licensed Independent Clinical Social Workers; • Advance Practice Registered Nurses (Clinical Nurse Specialists/Nurse Practitioners- Behavioral Health); • Licensed Mental Health Counselors; and • Licensed Marriage and Family Therapists. Psychological Testing This plan covers psychological testing as a behavioral health benefit when rendered by: • neuropsychologists; • psychologists; or • pediatric neurodevelopmental specialists. This plan covers neuropsychological testing as described in the Tests, Labs and Imaging section.
CONTRACTOR STAFF WITHIN AUTHORIZED USER AGREEMENT The provisions of this section shall apply unless otherwise agreed in the Authorized User Agreement. All employees of the Contractor, or of its Subcontractors, who shall perform under an Authorized User Agreement, shall possess the necessary qualifications, training, licenses, and permits as may be required within the jurisdiction where the Services specified are to be provided or performed, and shall be legally entitled to work in such jurisdiction. All Business Entities that perform Services under the Contract on behalf of Contractor shall, in performing the Services, comply with all applicable Federal, State, and local laws concerning employment in the United States. Staffing Changes within Authorized User Agreement
Employee and Family Assistance Program (a) A province-wide Employee and Family Assistance Program for employees and members of their immediate family, with whom the employee normally resides, shall be provided.
