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Hospital Care Sample Clauses

Hospital CareInpatient care (i.e. an overnight stay) in a hospital, hospice or residential medical care facility including any period of incapacity or subsequent treatment in connection with or consequent to such as inpatient care.
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Hospital CareInpatient care in a hospital, hospice or residential medical care facility, including any period of incapacity relating to the same condition;
Hospital Care. The TPA will develop adequate access to hospital facilities, which will be based on a standard of one (1) hospital within twenty-five (25) miles of a participant’s home. To the extent possible, based on urban versus rural considerations, the TPA will maintain these standards for all participants. The TPA will identify all network hospitals where the corresponding hospital-based providers are not fully under contract. The TPA must provide participants with adequate access to network hospitals capable of furnishing a full range of acute and tertiary services, including inpatient and emergency room services, and to ambulatory surgical facilities, rehabilitation facilities, and facilities for residential treatment of mental health disorders.
Hospital Care. The following hospital services are covered, (1) under the MHCN option when provided or referred by the MHCN, or (2) under the Community Provider option when authorized in advance by GHO: 1. Room and board, including private room when prescribed, and general nursing services. 2. Hospital services (including use of operating room, anesthesia, oxygen, x-ray, laboratory and radiotherapy services). 3. Alternative care arrangements may be covered as a cost-effective alternative in lieu of otherwise covered Medically Necessary hospitalization, or other covered Medically Necessary institutional care. Alternative care arrangements in lieu of covered hospital or other institutional care must be determined to be appropriate and Medically Necessary based upon the Member’s Medical Condition. Coverage must be authorized in advance by GHO as appropriate and Medically Necessary. Such care will be covered to the same extent the replaced Hospital Care is covered under the Agreement. 4. Drugs and medications administered during confinement. 5. Special duty nursing, when prescribed as Medically Necessary. Except as specifically provided below, all inpatient admissions prescribed by a Community Provider must be authorized by GHO at least seventy-two (72) hours in advance. Members receiving the following nonscheduled services are required to notify GHO by way of the GHO Notification Line within twenty-four (24) hours following a nonscheduled admission, or as soon thereafter as medically possible: labor and delivery, Emergency care services, and inpatient admissions needed for treatment of Urgent Conditions that cannot reasonably be delayed until preauthorization can be obtained. Members may not transfer to a MHCN hospital during a nonemergent, scheduled admission to a non-MHCN hospital. Coverage for Emergency care in a non-MHCN Facility and subsequent transfer to a MHCN Facility is set forth in Section IV.L.
Hospital Care. Enhanced Funding for MRP Physicians Admitting Unscheduled Patients 6.1.1 Effective October 1, 2009, a 30% increase will be targeted to key fee codes for MRP care (codes include: admission assessment codes C933, C122, C123, C124, C142, C143; subsequent visit codes Cxx2, Cxx7, Cxx9; and Cxx5 consultation codes). The increased codes will be billable by MRP physicians caring for patients admitted to hospital. Routine admissions for labour and delivery (including routine newborn assessments) will not be eligible for the enhanced MRP codes. The increased codes will reflect the importance and scope of the MRP role. 6.1.2 Access to the enhanced fee codes for MRP care by a physician will require an annual declaration by the physician’s hospital that there is no top-up or financial subsidies provided to that physician for direct or indirect MRP care. 6.1.3 The MOHLTC commits funding to provide peer support and best practice guidelines for hospitals and their hospitalists to reorganize their MRP program to meet the program requirements. 6.1.4 The Parties will examine the progress of hospitals that are not part of the enhanced program. 6.1.5 A further $33 million will be available for an incentive payment through the MRP Collaboration Initiative fund (Section 9.3) to recognize MRP physician groups at the hospital and LHIN level that receive enhanced fee codes for meeting established targets related to effective management of hospital patients. Key indicators: average length of stay, “may not require hospital” rate, and readmission rates. The incentive will be split to recognize both physician contributions at the LHIN level and at the hospital level (proposed 25/75 ratio).
Hospital Care confinement in a convalescent care facility which starts within days of discharge from a hospital, up to a maximum of per day for disability per disability charges for any portion of the cost of xxxx accommodation, utilization or fees (or similar charges) are not covered drugs or medicines dispensed by a licensed pharmacist, and which by law or convention require a written prescription of a physician or dentist oral contraceptives, intrauterine devices, and diaphragms injectable medications life-sustaining drugs
Hospital Care. Semi-private room and board. General medical and nursing services. Medical surgical/intensive care/coronary care unit. Laboratory tests, x-rays and other diagnostic procedures. Drugs [PIHP – not covered by Medicare Part D] and biologicals. Blood and blood derivatives. Surgical care, including the use of anesthesia. Use of oxygen. Physical, speech, occupational, and respiratory therapy services. Medical social services and discharge planning. Emergency room and ambulance services.
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Hospital Care charges, in excess of the hospital’s public xxxx charge, for semi-private accommodation, provided: the person was confined to hospital on an basis, and the accommodation was specifically elected in writing by the patient Semi-private accommodation for confinement in a chronic care facility which starts within days of discharge from a hospital confinement of at least days Semi-private accommodation for confinement in a nursing home, up to a maximum of per day charges for any portion of the cost of xxxx accommodation, utilization or fees (or similar charges) are not covered Charges incurredfor the following expenses are payablewhen prescribed in writing by a physician or dentist and dispensed by a licensed pharmacist. drugs or medicines for the treatment of an illness or injury, which by law or convention require the written prescription of a physician or dentist oral contraceptives injectable medications drugs preventive vaccines and medicines (oral or injected) diabetic supplies (excluding cotton swabs, rubbing alcohol, automatic jet injectors and similar equipment)
Hospital Care charges, in excess of the hospital’s public xxxx charge, for semi-private accommodation, provided: - the person was confined to hospital on an in-patient basis, and - the accommodation was specifically elected in writing by the patient • confinement in a chronic care facility which starts within 14 days of discharge from a hospital confinement of at least 5 days, up to a maximum of $20 per day for 180 days per disability • charges for any portion of the cost of xxxx accommodation, utilization or co-payment fees (or similar charges) are not covered
Hospital Care.  Semi-private room and board.  General medical and nursing services.  Medical surgical/intensive care/coronary care unit.  Laboratory tests, x-rays and other diagnostic procedures.  Drugs and biologicals.  Blood and blood derivatives.  Surgical care, including the use of anesthesia.  Use of oxygen.  Physical, speech, occupational and respiratory therapy services.  Medical social services and discharge planning.  Emergency room and ambulance services.
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