Footnotes 1 The Calendar Year Deductible (Medical Plan Deductible) may include Services on both a Copayment or Coinsurance basis and applies to all applicable Services except the Services listed below. Chiropractic Services; Covered travel expenses for bariatric surgery Services; Diabetes self-management training provided by Preferred Providers, a registered dietician or registered nurse who are certi- fied diabetes educators; Injectable contraceptive when administered by a Physician as specified in the Family Planning Services section; Internet Based Consultations; Outpatient Mental Health Care from MHSA Participating Providers for Severe Mental Illnesses or Serious Emotional Dis- turbances of a Child, including the initial visit to determine the condition and diagnosis of the Member; Outpatient routine newborn circumcision in a Preferred Providers’ office; Preferred Physician office visits; Services provided under the Outpatient Prescription Drug benefit; and Preventive Health Benefits; 2 Charges for covered Brand Name Drugs in excess of the Participating Pharmacy contracted rate do not apply to the Member Calendar Year Brand Name Drug Deductible. The Member Calendar Year Brand Name Drug Deductible must be satisfied once during each Calendar Year by or on behalf of the Member. The Member Calendar Year Brand Name Drug Deductible is separate from the Member Calendar Year Deductible (Medical Plan Deductible). The Member Calendar Year Brand Name Drug Deductible does not count towards the Member Calendar Year Deductible (Medical Plan Deductible) nor toward the Member Calendar Year Out-of-Pocket Maximum responsibility. 3 The following are not included in the Calendar Year Out-of-Pocket Maximum amount: Additional and reduced payments under the Benefits Management Program; Charges in excess of specified benefit maximums; Charges for Services which are not covered and charges by non-Preferred and MHSA Non-Participating Providers in ex- cess of covered amounts; Covered travel expenses for bariatric surgery Services; Family Planning injectable contraceptives administered by a Physician; Inpatient Hospital Facility Services for Mental Illness when Services are received from MHSA Non-Participating Provid- ers; Internet Based Consultations; Non-Emergency Services from a Non-Participating Hospital; Outpatient Mental Health Care from MHSA Participating Providers for Severe Mental Illnesses or Serious Emotional Disturbances of a Child, including the initial visit to determine the condition and diagnosis of the Member; Non-Preferred Hospital-based Inpatient Medically Necessary skilled nursing Services including Subacute Care; Outpatient Surgery from a Non-Participating Ambulatory Surgery Center; and Outpatient routine newborn circumcision in a Preferred Providers’ office; Physician office visit Copayment; Services as described in the Preventive Care Benefits section; Services provided under the Outpatient Prescription Drug benefit; The Calendar Year Medical Plan Deductible; The Calendar Year Brand Name Drug Deductible. Note: Copayments and charges for Services not accruing to the Calendar Year Out-of-Pocket Maximum Responsibility con- tinue to be the Member's responsibility after the Calendar Year Out-of-Pocket Maximum is reached. 4 Unless otherwise specified, Copayments/Coinsurance are calculated based on the Allowable Amount. 5 Other Providers are not Preferred Providers and so for Services by Other Providers you are responsible for all charges above the Allowable Amount. Other Providers include acupuncturists, nursing homes and certain labs (for a complete list of Other Providers see the Definitions section)
Schedules Schedules to this Agreement form a part of it.
Incorporation of Schedules and Exhibits The schedules, attachments and exhibits referenced in and attached to this Agreement shall be deemed an integral part hereof to the same extent as if written in whole herein. In the event that any inconsistency or conflict exists between the provisions of this Agreement and any schedules, attachments or exhibits attached hereto, the provisions of this Agreement shall supersede the provisions of any such schedules, attachments or exhibits.
Exhibits The exhibits to this Agreement are hereby incorporated and made a part hereof and are an integral part of this Agreement.
Documentation of Disclosures Business Associate agrees to document disclosures of PHI and information related to such disclosures as would be required for a Covered Entity to respond to a request by an individual for an accounting of disclosures of PHI in accordance with 45 C.F.R. 164.528 and HITECH.
Shift Schedules 1501 Shift schedules for a minimum of a four (4) week period shall be posted at least two (2) weeks in advance of the beginning of the scheduled period. Shifts within the minimum four (4) week period shall not be altered after posting except by mutual agreement between the nurse(s) concerned and the Employer. Requests for specific days off duty shall be submitted in writing at least two (2) weeks prior to posting and granted, if possible in the judgment of the Employer. 1502 Requests for interchanges in posted shifts or a portion thereof shall also be submitted in writing, co-signed by the nurse willing to exchange shifts with the applicant. Where reasonably possible, interchanges in posted shifts are to be completed within the posted shift schedule. It is understood that any change in shifts or days off initiated by the nurses and approved by the Employer shall not result in overtime costs to the Employer. 1503 Night shift shall be considered as the first shift of each calendar day. 1504 Master rotations for each nursing unit shall be planned by the Employer in meaningful consultation with the nurse(s) concerned. The process for meaningful consultation shall include: Employer proposes a master rotation including the Employer established criteria and provides to Nurses concerned Nurses are provided reasonable time to submit feedback and/or an alternate master rotation for consideration. The amended or new master rotation is provided to Nurses for review. Nurses are provided with a reasonable time to submit feedback. At each step of the consultation process the Union will be provided with the new or revised master rotation to ensure contract compliance. Employer has the sole discretion to select the new master rotation and provides rationale for the selection. Master Rotations shall, unless otherwise mutually agreed between the nurse(s) concerned and the Employer, observe the conditions listed hereinafter:
