Mental Health and Substance Abuse Benefits Sample Clauses

Mental Health and Substance Abuse Benefits. Blue Shield’s Mental Health Service Administrator (MHSA) arranges and administers Mental Health Services and Substance Abuse Services for Blue Shield Members within California. See the Out-Of- Area Program, BlueCard Program section for an explanation of how payment is made for out of state services. All Non-Emergency inpatient Mental Health and Substance Abuse Services, including Residential Care, and Non-Routine Outpatient Mental Health and Substance Abuse Services are subject to the Benefits Management Program and must be prior authorized by the MHSA. See the Benefits Management Program section for complete information.
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Mental Health and Substance Abuse Benefits. Blue Shield’s Mental Health Service Administra- tor (MHSA) arranges and administers Mental Health Services and Substance Abuse Services for Blue Shield Members within California. See the Out-Of-Area Program, BlueCard Program section for an explanation of how payment is made for out of state services. All Non-Emergency inpatient Mental Health and Substance Abuse Services, including Residential Care, and Non-Routine Outpatient Mental Health and Substance Abuse Services are subject to the Benefits Management Program and must be prior authorized by the MHSA. See the Benefits Man- agement Program section for complete informa- tion Benefits are provided for professional (Physician) office visits for the diagnosis and treatment of Mental Health Conditions and Substance Abuse Conditions in the individual, family or group set- ting Benefits are provided for Outpatient Facility and professional services for the diagnosis and treat- ment of Mental Health and Substance Abuse Con- ditions. These services may also be provided in the office, home or other non-institutional setting. Non-Routine Outpatient Mental Health and Sub- stance Abuse Services include, but may not be lim- ited to, the following:
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Mental Health and Substance Abuse Benefits. 11 All services provided through Blue Shield’s Mental Health Service Administrator (MHSA). Services by MHSA Participat- ing Providers Services by MHSA Non- Participating Providers 10 Inpatient Hospital services $100 per admission plus 10% 40% of up to $600 per day 12 Inpatient Professional (Physician) services You pay nothing 40% Residential care for Mental Health Condition $100 per admission plus 10% 40% of up to $600 per day Residential care for Substance Abuse Condition $100 per admission plus 10% 40% of up to $600 per day Behavioral Health Treatment in home or other non-institutional set- ting You pay nothing 40% Behavioral Health Treatment in an office-setting You pay nothing 40% Electroconvulsive Therapy (ECT) 14 You pay nothing 40% Intensive Outpatient Program 14 You pay nothing 40% Office-based opioid treatment: outpatient opioid detoxification and/or maintenance therapy including methadone maintenance treat- ment You pay nothing 40% Partial Hospitalization Program 13 You pay nothing per episode 40% of up to $350 per day per episode Psychological testing to determine mental health diagnosis You pay nothing 40% Transcranial magnetic stimulation You pay nothing 40% Professional (Physician) office visits 1 $30 per visit 40% Benefit Member Copayment 3 Services by Preferred, Participating, and Other Providers 4 Services by Non-Pre- ferred and Non-Partic- ipating Providers 5 Office visits 1 $30 per visit 40% Orthotic equipment and devices 10% 40% Outpatient Prescription Drug Benefits Outpatient Prescription Drug coverage if selected as an optional Benefit by your Employer, is described in a Supplement included with this booklet. Outpatient X-Ray, Pathology, and Laboratory Benefits Outpatient diagnostic X-ray, pathology, diagnostic examination and clinical laboratory Services, including mammography and Pa- panicolaou test. See Radiological and Nuclear Imaging Benefits for CT scans, MRIs, MRAs, PET scans, etc. Outpatient Laboratory Center or Outpatient Radiology Center Note: Preferred Laboratory Centers and Preferred Radiology Cen- ters may not be available in all areas. $30 per visit 40% Benefit Member Copayment 3 Services by Preferred, Participating, and Other Providers 4 Services by Non-Pre- ferred and Non-Partici- pating Providers 5 Formulas and Special Food Products 10% 10% Podiatric services – office location 1 $30 per visit 40% Pregnancy and Maternity Care Benefits Note: Routine newborn circumcision is only covered as de- scribed in the Covered Serv...
Sample 1
Mental Health and Substance Abuse Benefits. Blue Shield’s Mental Health Service Administra- tor (MHSA) arranges and administers Mental Health and Substance Abuse Services for Blue Shield Members within California. All non-emer- gency inpatient Mental Health and Substance Abuse Services, including Residential Care, and Non-Routine Outpatient Mental Health and Sub- stance Abuse Services must be prior authorized by the MHSA. Benefits are provided for professional office visits for the diagnosis and treatment of Mental Health and Substance Abuse Conditions in the individual, Family or group setting. Benefits are provided for Outpatient Facility and professional services for the diagnosis and treat- ment of Mental Health and Substance Abuse Conditions. These services may also be provided in the office, home or other non-institutional setting. Non-Routine Outpatient Mental Health and Sub- stance Abuse Services include, but may not be lim- ited to the following:
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Mental Health and Substance Abuse Benefits. The Department of Administrative Services, with the active consultation and review of the JHCC, shall develop and implement a managed mental health and substance abuse program for all State employees enrolled in either Ohio Med, an HMO or other managed care program. The program shall be effective July 1, 1995, or as soon thereafter as is practicable. Upon the effective date of the program, the State shall contract for State employee mental health and substance abuse benefits only under this program. Premiums for the managed mental health/substance abuse program shall be calculated into the Ohio Med premium and shall be added to the HMO premiums. Should the State, upon consultation with the JHCC, determine that this managed care program is unfeasible or will create an undue financial burden to the State and/or its employees, it may then cancel the program. Programs must include the following features: A. A full range of culturally diverse service providers, including psychiatrists, psychologists, social workers, and licensed and certified alcohol and drug counselors; B. A full range of facilities, including inpatient facilities and facilities for residential treatment (halfway houses, transitional programs, etc.); C. A full range of programs at various treatment levels, including inpatient treatment, a variety of intensive outpatient programs, and a variety of outpatient programs; D. A range of service providers and facilities within a reasonable distance in all parts of the state; E. Group programs on smoking cessation, stress management, weight control, family discord, and other like stress management issues; F. Timely responses to emergency calls; G. Protocols and programs for integrating mental health/substance abuse and other physical health programs; H. Coordination with the State Employee Assistance Program. I. No preset caps on employee visits or treatment; J. A provision that the program will pay the costs of treatment by a provider not included in the managed care network for those persons for whom an appropriate provider is not available in his/her home county; K. Separate standards and incentives, for the program to provide appropriate amounts of treatment at the various treatment levels (inpatient, intensive outpatient, etc.) and for discrete categories of illness (e.g. mental health, substance abuse, eating disorders): L. Use of the proper placement criteria; M. Separate, appropriate diagnostic capacity for discrete categories of illness (e.g....
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Mental Health and Substance Abuse Benefits. (1) In-patient treatment at the facilities listed in the attached sheet will be without limit subject to the same considerations as in the current program. (2) Out-patient treatment limits shall be $5,000 per year, subject to the total lifetime cap. (3) Treatment at facilities other than those listed in the attached shall be subject to a $25,000 per stay annual limit and a $50,000 lifetime limit. (4) The list of the approved facilities is subject to change by mutual agreement of the Township and the Superior Officers Association.
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Related to Mental Health and Substance Abuse Benefits

  • Behavioral Health Services – Mental Health and Substance Use Disorder Inpatient - Unlimited days at a general hospital or a specialty hospital including detoxification or residential/rehabilitation per plan year. Preauthorization may be required for services received from a non-network provider. 0% - After deductible 40% - After deductible Outpatient or intermediate careservices* - See Covered Healthcare Services: Behavioral Health Section for details about partial hospital program, intensive outpatient program, adult intensive services, and child and family intensive treatment. Preauthorization may be required for services received from a non-network provider. 0% - After deductible 40% - After deductible Office visits - See Office Visits section below for Behavioral Health services provided by a PCP or specialist. Psychological Testing 0% - After deductible 40% - After deductible Medication-assisted treatment - whenrenderedby a mental health or substance use disorder provider. 0% - After deductible 40% - After deductible Methadone maintenance treatment - one copayment per seven-day period of treatment. 0% - After deductible 40% - After deductible Outpatient - Benefit is limited to 18 weeks or 36 visits (whichever occurs first) per coveredepisode. 0% - After deductible 40% - After deductible In a physician's office - limited to 12 visits per plan year. 0% - After deductible 40% - After deductible Emergency room - When services are due to accidental injury to sound natural teeth. 0% - After deductible The level of coverage is the same as network provider. In a physician’s/dentist’s office - When services are due to accidental injury to sound natural teeth. 0% - After deductible 40% - After deductible Services connected to dental care when performed in an outpatient facility * 0% - After deductible 40% - After deductible Inpatient/outpatient/in your home 0% - After deductible 40% - After deductible (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Outpatient durable medical equipment* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Outpatient medical supplies* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Outpatient diabetic supplies/equipment purchasedat licensed medical supply provider (other than a pharmacy). See the Summary of Pharmacy Benefits for supplies purchased at a pharmacy. 20% - After deductible 40% - After deductible Outpatient prosthesis* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Enteral formula delivered through a feeding tube. Must be sole source of nutrition. 20% - After deductible 40% - After deductible Enteral formula or food taken orally * 20% - After deductible The level of coverage is the same as network provider. Hair prosthesis (wigs) - The benefit limit is $350 per hair prosthesis (wig) when worn for hair loss suffered as a result of cancer treatment. 20% - After deductible The level of coverage is the same as network provider. Coverage provided for members from birth to 36 months. The provider must be certified as an EIS provider by the Rhode Island Department of Human Services. 0% - After deductible The level of coverage is the same as network provider. Asthma management 0% - After deductible 40% - After deductible Hospital emergency room 0% - After deductible The level of coverage is the same as network provider.

  • Substance Abuse The dangers and costs that alcohol and other chemical abuses can create in the electrical contracting industry in terms of safety and productivity are significant. The parties to this Agreement resolve to combat chemical abuse in any form and agree that, to be effective, programs to eliminate substance abuse and impairment should contain a strong rehabilitation component. The local parties recognize that the implementation of a drug and alcohol policy and program must be subject to all applicable federal, state, and local laws and regulations. Such policies and programs must also be administered in accordance with accepted scientific principles, and must incorporate procedural safeguards to ensure fairness in application and protection of legitimate interests of privacy and confidentiality. To provide a drug-free workforce for the Electrical Construction Industry, each IBEW local union and NECA chapter shall implement an area-wide Substance Abuse Testing Policy. The policy shall include minimum standards as required by the IBEW and NECA. Should any of the required minimum standards fail to comply with federal, state, and/or local laws and regulations, they shall be modified by the local union and chapter to meet the requirements of those laws and regulations.

  • Mental Health The parties recognize the importance of supporting and promoting a psychologically healthy workplace and as such will adhere to all applicable statutes, policy, guidelines and regulations pertaining to the promotion of mental health.

  • Substance Abuse Program The SFMTA General Manager or designee will manage all aspects of the FTA-mandated Substance Abuse Program. He/she shall have appointing and removal authority over all personnel working for the Substance Abuse Program personnel, and shall be responsible for the supervision of the SAP.

  • Substance Abuse Treatment Information Substance abuse treatment information shall be maintained in compliance with 42 C.F.R. Part 2 if the Party or subcontractor(s) are Part 2 covered programs, or if substance abuse treatment information is received from a Part 2 covered program by the Party or subcontractor(s).

  • Substance Abuse Testing The Parties agree that it is in the best interest of all concerned to promote a safe working environment. The Union has no objection to pre-employment substance abuse testing when required by the Employer and further, the Union has no objection to voluntary substance abuse testing to qualify for employment on projects when required by a project owner. The cost and scheduling of such testing shall be paid for and arranged by the Employer. The Union agrees to reimburse the Employer for any failed pre-access Alcohol and Drug test costs.

  • Mental Health Services Grantee will receive allocated funding to secure Mental Health Services and Programs for youth under Xxxxxxx’s supervision. Services may include screening, assessment, diagnoses, evaluation, or treatment of youth with Mental Health Needs. The Department’s provision of State Aid Grant Mental Health Services funds shall not be understood to limit the use of other state and local funds for mental health services. State Aid Grant Mental Health Services funds may be used for all mental health services and programs as defined herein, however these funds may not be used to supplant local funds or for unallowable expenditure. Youth served by State Aid Grant Mental Health Services funds must meet the definition of Target Population for Mental Health Services provided in the Contract.

  • SUBSTANCE ABUSE POLICY See applicable administrative policy.

  • OCCUPATIONAL HEALTH AND SAFETY 34.01 The parties recognize the need for a safe and healthy workplace. The Employer shall be responsible for providing safe and healthy working conditions. The Employer and Employees will take all reasonable steps to eliminate, reduce or minimize all workplace safety hazards. Occupational health and safety education, training and instruction provided by the Employer, shall be paid at the Basic Rate of Pay, to fulfill the requirements for training, instruction or education set out in the Occupational Health and Safety Act, Regulation or Code. (a) There shall be an Occupational Health and Safety Committee (Committee), which shall be composed of representatives of the Employer and representatives of the Local and may include others representing recognized functional bargaining units. This Committee shall meet once a month, and in addition shall meet within 10 days of receiving a written complaint regarding occupational health or safety. An Employee shall be paid the Employee’s Basic Rate of Pay for attendance at Committee meetings. A request to establish separate committees for each site or grouping of sites shall not be unreasonably denied. The Employer shall provide training at no cost to all Employees on the Committee to assist them in performing their duties on the Committee. Training shall be paid at the Employee’s Basic Rate of Pay. (b) Minutes of each meeting shall be taken and shall be approved by the Employer, the Local, and other bargaining groups, referred to in (a), prior to circulation. (c) The purpose of the Committee is to consider such matters as occupational health and safety and the Local may make recommendations to the Employer in that regard. (d) If an issue arises regarding occupational health or safety, the Employee or the Local shall first seek to resolve the issue through discussion with the applicable immediate supervisor in an excluded management position. If the issue is not resolved satisfactorily, it may then be forwarded in writing to the Committee. (e) The Committee shall also consider measures necessary to ensure the security of each Employee on the Employer’s premises and the Local may make recommendations to the Employer in that regard. (f) (i) Should an issue not be resolved by the Committee, the issue shall be referred to the Chief Executive Officer (CEO). A resolution meeting between the Local and the CEO, or designate(s), shall take place within 21 calendar days of the issue being referred to the CEO. The CEO or designate(s) shall reply in writing to the Local within seven (7) calendar days of the resolution meeting.

  • Environmental Health and Safety i. Environment, Health and Safety Performance. Seller acknowledges and accepts full and sole responsibility to maintain an environment, health and safety management system ("EMS") appropriate for its business throughout the performance of this Contract. Buyer expects that Seller’s EMS shall promote health and safety, environmental stewardship, and pollution prevention by appropriate source reduction strategies. Seller shall convey the requirement of this clause to its suppliers. Seller shall not deliver goods that contain asbestos mineral fibers.

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