Excluded Services. All Coverage Types Except as otherwise noted or determined Medically Necessary by EOHHS, the following services are not covered under MassHealth and as such are not covered by the Contractor.
Excluded Services. 5.1. Service excludes the repair or replacement of Equipment that has become defective or damaged from use in other than the normal, customary, intended, and authorized manner; use not in compliance with applicable industry standards; excessive wear and tear; or accident, liquids, power surges, neglect, acts of God or other force majeure events.
Excluded Services. Orders for the following services will not count towards calculation of expenditure against the Commitment Value:
Excluded Services. Except as otherwise agreed to in writing between the parties, neither Blue Cross and Blue Shield nor its designated vendor(s) will provide any services not described in this Account-Based Offerings Administrative Services Agreement or your Group Setup Form, including but not limited to: continuation of coverage administration as otherwise required under COBRA for the HRA and/or HC-FSA (including but not limited to the distribution of notices otherwise required under COBRA); and Department of Labor Form 5500 preparation for the HRA, TFS, PFS, and/or HC-FSA.
Excluded Services. The Hoosier Healthwise program exclude some benefits from coverage under managed care. These benefits are available under traditional Medicaid or other waiver programs and are therefore excluded from the programs as described below. A member who is, or will be, receiving excluded services must be disenrolled from managed care in order to be eligible for the services. The Contractor is responsible for the member’s care until the member is disenrolled from the plan unless stated otherwise. The Hoosier Healthwise MCE Policies and Procedures Manual describe member disenrollment in greater detail. Listed below are the services excluded from the Hoosier Healthwise program.
Excluded Services. 6.1 The Services to be rendered under this Agreement do not include:
Excluded Services. The Hoosier Care Connect program excludes some benefits from coverage under managed care. These excluded benefits are available under traditional Medicaid. A Contractor’s members who are, or will be, receiving excluded services shall be disenrolled from Hoosier Care Connect and enrolled in traditional Medicaid. The Contractor is responsible for the member’s care until the member is disenrolled by FSSA unless otherwise stated.
Excluded Services. The HIP program excludes some benefits from coverage under managed care. These benefits are available under Traditional Medicaid or other waiver programs and are therefore excluded from the programs as described below. A member who is, or will be, receiving excluded services must be disenrolled from managed care in order to be eligible for these services. The HIP MCE Policies and Procedures Manual describe member disenrollment in greater detail. Listed below are the services excluded from the HIP program.
Excluded Services. Excluded Services shall be defined as those services that Members may obtain under the South Carolina State Plan but for which the CONTRACTOR is not financially responsible. The CONTRACTOR shall:
Excluded Services. The parties hereto expressly acknowledge that the provision of all professional services, including but not limited to, dental services by the P.C., shall be separate and independent from the provision of administrative, fiscal and support services by VFD, and the P.C. shall be solely and exclusively responsible for all professional dental services rendered to patients of the Practice. Without limiting the generality of the foregoing, the parties acknowledge that the P.C. shall be solely responsible for setting all professional standards of the Practice and shall be responsible for the employment and discharge of all Professional Personnel.
