Experimental or Investigational Services Sample Clauses

Experimental or Investigational Services. 7. Cosmetic Surgery We will not pay for cosmetic surgery, unless medically necessary, except that we will pay for reconstructive surgery: • When following surgery resulting from trauma, infection or other diseases of the part of the body involved; or • When required to correct a functional defect resulting from congenital disease or anomaly.
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Experimental or Investigational Services. The Plan does not provide Benefits for any drugs, supplies, services, or equipment that are Experimental or Investigational as defined in this Agreement. The Plan does not provide Benefits for costs related to the provision of Experimental or Investigational drugs, supplies, services, or equipment. These exclusions do not apply when coverage is required by law. The Plan does not provide Benefits for laboratory tests that have not been approved by the FDA. The Plan does not provide Benefits for the Anser IFX test. Statement for New Technology: Health Options recognizes the need to evaluate coverage of new clinical technology by the Health Options health plans. Health Options reviews requests to evaluate new technologies from a variety of sources. If you would like a copy of Health Options’ procedure for reviewing new technology, please call Member Services at 0-000-000-0000.
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Experimental or Investigational Services. The Plan does not provide Benefits for any drugs, supplies, services, laboratory tests or equipment that are Experimental or Investigational as defined in this Agreement. The Plan does not provide Benefits for costs related to the provision of Experimental or Investigational drugs, supplies, services, or equipment. These exclusions do not apply when coverage is required by law. The Plan does not provide Benefits for non-FDA approved services and FDA approved services must be used in accordance as approved by the FDA. The Plan does not provide Benefits for laboratory tests that have not been approved by the FDA unless performed by a CLIA certified laboratory for medically necessary tests. SAMPLE Statement for New Technology: Health Options recognizes the need to evaluate coverage of new clinical technology and evidence based practice. Health Options reviews requests to evaluate new technologies from a variety of sources. If you would like a copy of Health Options’ procedure for reviewing new technology, please call Member Services at 0-000-000-0000.
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Experimental or Investigational Services. The Plan restricts coverage to those procedures (including behavioral health procedures), treatments, services, equipment, supplies, devices, drugs, medications, and biologics for which the safety and efficacy have been proven, or where the clinical evidence is such that the treatment is at least as beneficial as any established evidence-based alternatives. Any procedures (including behavioral health procedures), treatments, services, equipment, supplies, devices, drugs, medications, and biologics for which safety and efficacy has not been established and proven, Community Health Options considers Experimental or Investigational as defined in this Agreement and therefore is not medically necessary and excluded from coverage. The Plan does not provide Benefits for costs related to the provision of Experimental or Investigational drugs, supplies, services, or equipment. These exclusions do not apply when coverage is required by law. The Plan does not provide Benefits for non-FDA approved services and FDA approved services must be used in accordance as approved by the FDA . The Plan does not provide Benefits for laboratory tests that have not been approved by the FDA unless performed by a CLIA certified laboratory for medically necessary tests. Statement for New Technology: Community Health Options recognizes the need to evaluate coverage of new clinical technology and based practice. Community Health Options reviews requests to evaluate new technologies from a variety of sources. If you would like a copy of Community Health Options’ procedure for reviewing new technology, please call Member Services.
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Experimental or Investigational Services. Except as specifically provided in this paragraph, we will not provide benefits for services which we determine are Experimental or Investigational Services. However, we will provide benefits, to the extent required by law, to cover routine costs for patients who participate in approved cancer clinical trials. See Section Two paragraph Z.
Sample 1
Experimental or Investigational Services. The Plan does not provide Benefits for any drugs, supplies, services, laboratory tests or equipment that are Experimental or Investigational as defined in this Agreement. The Plan does not provide Benefits for costs related to the provision of Experimental or Investigational drugs, supplies, services, or equipment. These exclusions do not apply when coverage is required by law. The Plan does not provide Benefits for laboratory tests that have not been approved by the FDA. Statement for New Technology: Health Options recognizes the need to evaluate coverage of new clinical technology and evidence based practice. Health Options reviews requests to evaluate new technologies technology, please call Member Services at 1 - 855 - 624 - 6463.
Sample 1

Related to Experimental or Investigational Services

  • Investigational Services This plan covers certain experimental or investigational services as described in this section. Clinical Trials This plan covers clinical trials as required under R.I. General Law § 27-20-60. An approved clinical trial is a phase I, phase II, phase III, or phase IV clinical trial that is being performed to prevent, detect or treat cancer or a life-threatening disease or condition. In order to qualify, the clinical trial must be: • federally funded; • conducted under an investigational new drug application reviewed by the Food and Drug Administration (FDA); or • a drug trial that is exempt from having such an investigational new drug application. To qualify to participate in a clinical trial: • you must be determined to be eligible, according to the trial protocol; • a network provider must have concluded that your participation would be appropriate; and • medical and scientific information must have been provided establishing that your participation in the clinical trial would be appropriate. If a network provider is participating in a clinical trial, and the trial is being conducted in the state in which you reside, you may be required to participate in the trial through the network provider. Coverage under this plan includes routine patient costs for covered healthcare services furnished in connection with participation in a clinical trial. The amount you pay is based on the type of service you receive. Coverage for clinical trials does not include: • the investigational item, device, or service itself; • items or services provided solely to satisfy data collection and that are not used in the direct clinical management; or • a service that is clearly inconsistent with widely accepted standards of care.

  • Formal Investigation Once the matter has been brought to the attention of the Store executive, an internal investigation of the complaint will be conducted at which time the complainant will be requested to present, in writing, the particulars of the harassment. Such internal investigation will be initiated no later than ten (10) business days of the matter being brought to the attention of the Store executive, and shall be concluded no later than thirty (30) business days of the initiation of the investigation. Any extension of the aforementioned time frames must have the agreement of the complainant and the union if the complainant has chosen to involve it. Based on the outcome of the investigation, which will be provided in writing upon the completion of the investigation, to both the complainant and the union, should the complainant consent to this disclosure, it will be determined if there has been a breach of Company policy on harassment, and the appropriate action will be taken in the event that harassment is determined to have occurred. STEP THREE - SUBSEQUENT INCIDENTS Subsequent incidents should immediately be reported and followed by a written description to the most senior store executive involved in Step Two for further investigation and disciplinary action, if confirmed, with a copy to the union Chairperson with the consent of the complainant. After all steps of the Harassment Protection Policy have been exhausted, if the incident has not been resolved to the satisfaction of the employee, the employee may file a grievance at Step 2 of the grievance procedure.

  • Geotechnical Investigation Perform in accordance with the City Design Manual and other City requirements as designated in writing by the Director.

  • Grievance Investigation The Employer agrees to supply to the Union the names of all applicants for a vacancy, or new position in the course of a grievance investigation.

  • Investigation of Grievances The investigation of grievances shall not interfere with the orderly process of education in District 281.

  • Independent Investigation Subscriber, in making the decision to purchase the Units, has relied upon an independent investigation of the Company and has not relied upon any information or representations made by any third parties or upon any oral or written representations or assurances from the Company, its officers, directors or employees or any other representatives or agents of the Company, other than as set forth in this Agreement. Subscriber is familiar with the business, operations and financial condition of the Company and has had an opportunity to ask questions of, and receive answers from the Company’s officers and directors concerning the Company and the terms and conditions of the offering of the Units and has had full access to such other information concerning the Company as Subscriber has requested. Subscriber confirms that all documents that it has requested have been made available and that Subscriber has been supplied with all of the additional information concerning this investment which Subscriber has requested.

  • Investigation To make investigation about the accuracy of representations, warranties or other obligations of the Issuer under the Transaction Documents.

  • TECHNOLOGY/KNOWLEDGE TRANSFER ACTIVITIES The goal of this task is to develop a plan to make the knowledge gained, experimental results, and lessons learned available to the public and key decision makers. The Recipient shall: • Prepare an Initial Fact Sheet at start of the project that describes the project. Use the format provided by the CAM. • Prepare a Final Project Fact Sheet at the project’s conclusion that discusses results. Use the format provided by the CAM. • Prepare a Technology/Knowledge Transfer Plan that includes: o An explanation of how the knowledge gained from the project will be made available to the public, including the targeted market sector and potential outreach to end users, utilities, regulatory agencies, and others.

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