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.
Benchmarks for Measuring Accessibility For the purposes of this Agreement, the accessibility of online content and functionality will be measured according to the W3C’s Web Content Accessibility Guidelines (WCAG) 2.0 Level AA and the Web Accessibility Initiative Accessible Rich Internet Applications Suite (WAI-ARIA) 1.0 for web content, which are incorporated by reference. Adherence to these accessible technology standards is one way to ensure compliance with the College’s underlying legal obligations to ensure that people with disabilities are able to acquire the same information, engage in the same interactions, and enjoy the same benefits and services within the same timeframe as their nondisabled peers, with substantially equivalent ease of use; that they are not excluded from participation in, denied the benefits of, or otherwise subjected to discrimination in any College programs, services, and activities delivered online, as required by Section 504 and the ADA and their implementing regulations; and that they receive effective communication of the College’s programs, services, and activities delivered online.
Service Eligibility Criteria 4.3.4.1 High capacity EELs must comply with the following service eligibility requirements:
General Criteria a) Approved varieties shall be those varieties recommended by the Department, the Corporation, or those listed in the Atlantic Provinces Field Crop Guide, Publication 100A.
Behavioral Objectives In order to attain this competency, the student should be able to:
Performance indicators and targets The purpose of the innovation performance indicators and targets is to assist the University and the Commonwealth in monitoring the University's progress against the Commonwealth's objectives and the University's strategies for innovation. The University will report principal performance information and aim to meet the innovation performance indicators and targets set out in the following tables.
Exclusion Criteria Subjects fulfilling any of the following criteria are not eligible for participation in this study.
Selection Criteria for Awarding Task Order The Government will award to the offeror whose proposal is deemed most advantageous to the Government based upon an integrated assessment using the evaluation criteria. The Government will evaluate proposals against established selection criteria specified in the task order RFP. Generally, the Government's award decision will be based on selection criteria which addresses past performance, technical acceptability, proposal risk and cost. Among other sources, evaluation of past performance may be based on past performance assessments provided by TO Program Managers on individual task orders performed throughout the life of the contract. The order of importance for the factors will be identified in the RFP for the specified task order.
Criteria (1) Annual Evaluation Criteria. All performance evaluations shall be based upon assigned duties, and shall carefully consider the nature of the assignment in terms, where applicable, of:
Corrective Measures If the Participating Generator fails to meet or maintain the requirements set forth in this Agreement and/or the CAISO Tariff, the CAISO shall be permitted to take any of the measures, contained or referenced in the CAISO Tariff, which the CAISO deems to be necessary to correct the situation.
