Abortions. (a) The Contractor agrees that none of the funds paid through this contract, and none of the funds in any trust fund paid through this contract, shall be expended for any abortion.
(b) The Contractor agrees that none of the funds paid through this contract, and none of the funds in any trust fund paid through this contract, shall be expended for health benefits coverage that includes coverage of abortion.
(c) The term ‘‘health benefits coverage’’ means the package of services covered by a managed care provider or organization pursuant to a contract or other arrangement. (Sec. 506)
Abortions. 2.7.8.4.1 The CONTRACTOR shall cover abortions and services associated with the abortion procedure only if the pregnancy is the result of an act of rape or incest; or in the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed.
2.7.8.4.2 The CONTRACTOR shall ensure that a “CERTIFICATION OF MEDICAL NECESSITY FOR ABORTION” form, which is available on TENNCARE’s web site, is completed. The form shall be available in English and Spanish, and assistance shall be provided in completing the form when an alternative form of communication is necessary.
Abortions. 11. In Lieu of Services (ILOS)
a. The settings or services listed below are determined by OHA to be a Medically Appropriate and Cost-Effective substitute for a Covered Service consistent with provisions in OAR 410-141- 3820. Contractor may choose to offer one or more of the following ILOS:
Abortions. The Plan does not provide Benefits for abortions for which Federal funding is not allowed in accordance with the Affordable Care Act, namely all abortions except in the case of rape or incest, or for a pregnancy which, as certified by a physician, places the woman in danger of death unless an abortion is performed. ]
Abortions. In Lieu of Services (ILOS)
Abortions. The CONTRACTOR shall:
Abortions. The PCO may only provide for abortion in cases of rape, incest or when the life of the Member is in danger.
Abortions. Contractor must provide information in its Member Handbook expressly advising its COFA and Veteran Members that neither OHA nor Contractor provide NEMT services, nor support for or access to physical health and Behavioral Health services which are Non-Covered Services without Care Coordination.
Abortions. The CONTRACTOR shall:
4.2.1.1 Ensure abortions are performed in accordance with 42 CFR 441, Subpart E and the requirements of the Hyde Amendment (Departments of Labor, Health and Human Services, Education, and Related Agencies Appropriations Act, 1998, Public Law 105-78, §§ 509 and 510).
4.2.1.2 Submit a completed abortion statement form and any other documentation reporting requirements outlined in the Managed Care Policy and Procedure Guide.
4.2.1.3 Be reimbursed for abortion services only if performed in accordance with all federal, state and Department provisions.
Abortions. The Recipient agrees that none of the funds paid through this contract, and none of the funds in any trust fund paid through this contract, shall be expended for any abortion.
