Common use of Continuation of Inpatient Services Clause in Contracts

Continuation of Inpatient Services. A Member who is receiving Covered Services in a hospital on the date of termination shall continue to be eligible for Covered Services while an inpatient for the condition which the Member was hospitalized, until one of the following events occurs:  According to KFHPWA clinical criteria, it is no longer Medically Necessary for the Member to be an inpatient at the facility.  The remaining benefits available for the hospitalization are exhausted, regardless of whether a new calendar year begins.  The Member becomes covered under another agreement with a group health plan that provides benefits for the hospitalization.  The Member becomes enrolled under an agreement with another carrier that provides benefits for the hospitalization. This provision will not apply if the Member is covered under another agreement that provides benefits for the hospitalization at the time coverage would terminate.

Continuation of Inpatient Services. ‌ A Member who is receiving Covered Services in a hospital on the date of termination shall continue to be eligible for Covered Services while an inpatient for the condition which the Member was hospitalized, until one of the following events occurs:  • According to KFHPWA clinical criteria, it is no longer Medically Necessary for the Member to be an inpatient at the facility.  • The remaining benefits available for the hospitalization are exhausted, regardless of whether a new calendar year begins.  • The Member becomes covered under another agreement with a group health plan that provides benefits for the hospitalization.  • The Member becomes enrolled under an agreement with another carrier that provides benefits for the hospitalization. This provision will not apply if the Member is covered under another agreement that provides benefits for the hospitalization at the time coverage would terminate.

Continuation of Inpatient Services. ‌ A Member who is receiving Covered Services in a hospital on the date of termination shall continue to be eligible for Covered Services while an inpatient for the condition which the Member was hospitalized, until one of the following events occurs:  DRAFT • According to KFHPWA clinical criteria, it is no longer Medically Necessary for the Member to be an inpatient at the facility.  • The remaining benefits available for the hospitalization are exhausted, regardless of whether a new calendar year begins.  • The Member becomes covered under another agreement with a group health plan that provides benefits for the hospitalization.  • The Member becomes enrolled under an agreement with another carrier that provides benefits for the hospitalization. This provision will not apply if the Member is covered under another agreement that provides benefits for the hospitalization at the time coverage would terminate.

Continuation of Inpatient Services. A Member who is receiving Covered Services in a hospital on the date of termination shall continue to be eligible for Covered Services while an inpatient for the condition which the Member was hospitalized, until one of the following events occurs:  • According to KFHPWA clinical criteria, it is no longer Medically Necessary for the Member to be an inpatient at the facility.  • The remaining benefits available for the hospitalization are exhausted, regardless of whether a new calendar year begins.  • The Member becomes covered under another agreement with a group health plan that provides benefits for the hospitalization.  • The Member becomes enrolled under an agreement with another carrier that provides benefits for the hospitalization. This provision will not apply if the Member is covered under another agreement that provides benefits for the hospitalization at the time coverage would terminate.