Medical Necessity We Cover benefits described in this Contract as long as the dental service, procedure, treatment, test, device, or supply (collectively, “service”) is Medically Necessary e.g. orthodontia. The fact that a Provider has furnished, prescribed, ordered, recommended, or approved the service does not make it Medically Necessary or mean that We have to Cover it. We may base Our decision on a review of: • Your dental records; • Our dental policies and clinical guidelines; • Dental opinions of a professional society, peer review committee or other groups of Physicians; • Reports in peer-reviewed dental literature; • Reports and guidelines published by nationally-recognized health care organizations that include supporting scientific data; • Professional standards of safety and effectiveness, which are generally-recognized in the United States for diagnosis, care, or treatment; • The opinion of health care professionals in the generally-recognized health specialty involved; • The opinion of the attending Providers, which have credence but do not overrule contrary opinions. Services will be deemed Medically Necessary only if: • They are clinically appropriate in terms of type, frequency, extent, site, and duration, and considered effective for Your illness, injury, or disease; • They are required for the direct care and treatment or management of that condition; • Your condition would be adversely affected if the services were not provided; • They are provided in accordance with generally-accepted standards of dental practice; • They are not primarily for the convenience of You, Your family, or Your Provider; • They are not more costly than an alternative service or sequence of services, that is at least as likely to produce equivalent therapeutic or diagnostic results; • When setting or place of service is part of the review, services that can be safely provided to You in a lower cost setting will not be Medically Necessary if they are performed in a higher cost setting. See the Utilization Review and External Appeal sections of this Contract for Your right to an internal Appeal and external appeal of Our determination that a service is not Medically Necessary.
Proposed Policies and Procedures Regarding New Online Content and Functionality By October 31, 2017, the School will submit to OCR for its review and approval proposed policies and procedures (“the Plan for New Content”) to ensure that all new, newly-added, or modified online content and functionality will be accessible to people with disabilities as measured by conformance to the Benchmarks for Measuring Accessibility set forth above, except where doing so would impose a fundamental alteration or undue burden. a) When fundamental alteration or undue burden defenses apply, the Plan for New Content will require the School to provide equally effective alternative access. The Plan for New Content will require the School, in providing equally effective alternate access, to take any actions that do not result in a fundamental alteration or undue financial and administrative burdens, but nevertheless ensure that, to the maximum extent possible, individuals with disabilities receive the same benefits or services as their nondisabled peers. To provide equally effective alternate access, alternates are not required to produce the identical result or level of achievement for persons with and without disabilities, but must afford persons with disabilities equal opportunity to obtain the same result, to gain the same benefit, or to reach the same level of achievement, in the most integrated setting appropriate to the person’s needs. b) The Plan for New Content must include sufficient quality assurance procedures, backed by adequate personnel and financial resources, for full implementation. This provision also applies to the School’s online content and functionality developed by, maintained by, or offered through a third-party vendor or by using open sources. c) Within thirty (30) days of receiving OCR’s approval of the Plan for New Content, the School will officially adopt, and fully implement the amended policies and procedures.
Personal Necessity A maximum of eight (8) days of accumulated sick leave may be used in any school year for personal necessity leave for any of the following reasons:
Procedures for Providing NP Through Full NXX Code Migration Where a Party has activated an entire NXX for a single Customer, or activated at least eighty percent (80%) of an NXX for a single Customer, with the remaining numbers in that NXX either reserved for future use by that Customer or otherwise unused, if such Customer chooses to receive Telephone Exchange Service from the other Party, the first Party shall cooperate with the second Party to have the entire NXX reassigned in the LERG (and associated industry databases, routing tables, etc.) to an End Office operated by the second Party. Such transfer will be accomplished with appropriate coordination between the Parties and subject to appropriate industry lead times for movements of NXXs from one switch to another. Neither Party shall charge the other in connection with this coordinated transfer.
Interoperability To the extent required by applicable law, Cisco shall provide You with the interface information needed to achieve interoperability between the Software and another independently created program. Cisco will provide this interface information at Your written request after you pay Cisco’s licensing fees (if any). You will keep this information in strict confidence and strictly follow any applicable terms and conditions upon which Cisco makes such information available.
Freedom of Information and Transparency 20.1 The Recipient acknowledges that the Commissioner is subject to the provisions of the FOIA and agrees to assist and co-operate with the Commissioner (at the Recipient’s expense) where necessary to enable the Commissioner to comply with any requests received under the FOIA relating to this Agreement. This includes, but is not limited to, transferring to the Commissioner any request received by the Recipient under the FOIA relating to this Agreement as soon as practicable following receipt and in any event within three working days of receipt. 20.2 In no event shall the Recipient respond to a request under the FOIA relating to this Agreement without obtaining the prior written consent of the Commissioner. 20.3 The Recipient acknowledges that the Commissioner may be obliged to disclose information under the FOIA: 20.3.1 Without consulting the Recipient; or 20.3.2 Following consultation with the Recipient and having taken into account its views. Provided that where clause 20.3.1 applies the Commissioner shall, in accordance with the recommendations of the Secretary of State for Constitutional Affairs’ Code of Practice on the discharge of a public authorities’ functions under Part 1 of FOIA, take reasonable steps, to give the Recipient advanced notice or to draw the disclosure to the Recipient’s attention after any such disclosure. 20.4 The Recipient shall ensure it retains for disclosure all information (as defined in the FOIA) produced in the course of this Agreement or relating to this Agreement and shall allow the Commissioner to inspect such records from time to time upon request. 20.5 The Recipient acknowledges that the Commissioner is subject to certain transparency and disclosure obligations set out in the Elected Local Policing Bodies Specified Information Order 2011 (as amended) (“Transparency Obligations”) 20.6 The Recipient consents to the Commissioner publishing the contents of this Agreement and information regarding any tender process related to the Purpose of the Agreement to enable the Commissioner to comply with their Transparency Obligations. 20.7 The Recipient acknowledges that: 20.7.1 The Commissioner shall be responsible for determining, at their absolute discretion, whether any information is exempt from disclosure or should be disclosed pursuant to the FOIA and/or the Transparency Obligations and to what extent any information disclosed shall be redacted; and 20.7.2 Any lists or schedules provided by the Recipient outlining confidential information are of an indicative value only and that the Commissioner may be obliged to disclose confidential information in accordance with Clause 20.3 and/or Clause 20.5.
Open and Transparent Consistent with ICANN’s expressed mission and core values, ICANN shall operate in an open and transparent manner.
Skidding and Yarding Methods of skid- ding or yarding specified for particular areas, if any, are indicated on Sale Area Map. Outside Clearcutting Units and construction clearings, insofar as ground conditions permit, products shall not be skidded against reserve trees or groups of reproduction and tractors shall be equipped with a winch to facilitate skidding. B6.421 Rigging. Insofar as practicable, needed rigging shall be slung on stumps or trees desig- nated for cutting.
Your Content Certain of our Services may a low you to upload, post, transmit or make available content and materials to or through them(“Your Content”). You agree that you are responsible for Your Content and we sha l not, except as otherwise set forth herein, be responsible for Your Content. You represent that you own a l Inte lectual Property Rights (as defined below) in Your Content.
Tests, Labs, and Imaging and X rays (diagnostic)