Covered Services Organ Transplantations Sample Clauses

Covered Services Organ Transplantations. 4.8.1 Organ Transplantations, Generally (A) All organ transplantation services are Covered Services for all Enrollees in accordance with the criteria set forth in Utah Administrative Code R414-10A. Both Parties agree that all transplant services will be provided by in-network and in-state Providers unless the service is not available, as determined by the Contractor in consultation with its Network Providers, and must be performed by a Non-Network Provider or Out-of-State Provider. (B) In accordance with Section 1903(i) of the Social Security Act, the Contractor is prohibited from paying for organ transplantations unless the Contractor follows the criteria set forth in the State Plan, Utah Administrative Code R414-10A and ensures that similarly situated individuals are treated alike and that any restrictions on facilities or providers be consistent with the accessibility of high quality care to Enrollees.
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Covered Services Organ Transplantations 
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Related to Covered Services Organ Transplantations

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