Mental Health Parity Compliance Sample Clauses

Mental Health Parity Compliance. (BadgerCare Plus and Medicaid SSI) The BadgerCare Plus and Medicaid SSI HMO must comply with the Mental Health Parity Rule requirements of 42 CFR § 438.930. The Mental Health Parity Rule, in 42 CFR § 438.910(b)(2), requires the HMO to provide mental health or substance abuse benefits to members in every classification in which medical benefits are provided (e.g., inpatient, outpatient, emergency care, prescription drugs). The HMO must not establish any of the following when it has been determined that mental health or substance abuse treatment is medically necessary for the member: a. Any aggregate lifetime or annual dollar limits on mental health or substance abuse benefits; b. Any financial requirement or treatment limitation to mental health or substance abuse benefits; c. Any limit on the number of hours of outpatient treatment that the HMO must provide or reimburse; and d. Any monetary limit or limit on the number of days of inpatient hospital treatment. The HMO prior authorization requirements must comply with the requirements for parity in mental health and substance abuse benefits in 42 CFR § 438.910 (d). The same section of the Mental Health Parity Rule also specifies that the HMO may not impose non-quantitative treatment limits (NQTL) for mental health or substance abuse benefits in any classification unless, the HMO has processes, strategies evidentiary standards, or other factors used in applying the NQTL to mental health or substance abuse benefits that are comparable to, and are applied no more stringently than, the processes, strategies, evidentiary standards, or other factors used in applying the limitation for medical benefits. Pursuant to 42 CFR Part 438, subpart K, the HMO will be required to submit to the Department a parity analysis of its benefit plans as part of the HMO certification application process and upon request. Clarifying instructions will be included in the certification application. Additional information on covered services is available in Addendum V, as well as in Provider Updates and through interChange.
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Mental Health Parity Compliance. (BadgerCare Plus and Medicaid SSI) The BadgerCare Plus and Medicaid SSI HMO must comply with the Mental Health Parity Rule requirements of 42 CFR § 438.930. The Mental Health Parity Rule, in 42 CFR § 438.910(b)(2), requires the HMO to provide mental health or substance abuse benefits to members in every classification in which medical benefits are provided (e.g., inpatient, outpatient, emergency care, prescription drugs). The HMO must not establish any of the following when it has been determined that mental health or substance abuse treatment is medically necessary for the member:
Mental Health Parity Compliance. (BadgerCare Plus and Medicaid SSI) The BadgerCare Plus and Medicaid SSI HMO must comply with the Mental Health Parity Rule requirements of 42 CFR § 438.930. The Mental Health Parity Rule, in 42 CFR § 438.910(b)(2), requires the HMO to provide mental health or substance abuse benefits to members in every classification in which medical benefits are provided (e.g., inpatient, outpatient, emergency care, prescription drugs). The HMO must not establish any of the following when it has been determined that mental health or substance abuse treatment is medically necessary for the member: a. Any aggregate lifetime or annual dollar limits on mental health or substance abuse benefits; b. Any financial requirement or treatment limitation to mental health or substance abuse benefits;

Related to Mental Health Parity Compliance

  • 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.

  • Public safety compliance The Hirer shall comply with all conditions and regulations made in respect of the premises by the Fire Authority, Local Authority, the Licensing Authority or otherwise, particularly in connection with any event which constitutes regulated entertainment, at which alcohol is sold or provided or which is attended by children. (a) The Hirer acknowledges that they have received information in the following matters: (b) In advance of an entertainment or play the Hirer shall check the following items:

  • OSHA Compliance To the extent applicable to the services to be performed under this Agreement, Contractor represents and warrants, that all articles and services furnished under this Agreement meet or exceed the safety standards established and promulgated under the Federal Occupational Safety and Health Law (Public Law 91-596) and its regulations in effect or proposed as of the date of this Agreement.

  • Safety Compliance Comply with Site safety programs, as they apply to RPR, and if required to do so by such safety programs, receive safety training specifically related to RPR’s own personal safety while at the Site.

  • CRA Compliance Neither Buyer nor any Buyer Subsidiary has received any notice of non-compliance with the applicable provisions of the CRA and the regulations promulgated thereunder. As of the date hereof, Buyer Sub received a CRA rating of “satisfactory” or better from the FDIC in its most recent examination. Buyer knows of no fact or circumstance or set of facts or circumstances which would be reasonably likely to cause Buyer or any Buyer Subsidiary to receive any notice of non-compliance with such provisions or cause the CRA rating of Buyer or any Buyer Subsidiary to decrease below the “satisfactory” level.

  • Mental Health Services This agreement covers medically necessary services for the treatment of mental health disorders in a general or specialty hospital or outpatient facilities that are: • reviewed and approved by us; and • licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a general or specialty hospital or outpatient facility. We review network and non-network programs, hospitals and inpatient facilities, and the specific services provided to decide whether a preauthorization, hospital or inpatient facility, or specific services rendered meets our program requirements, content and criteria. If our program content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below.

  • Health Care Compliance Neither the Company nor any Affiliate has, prior to the Effective Time and in any material respect, violated any of the health care continuation requirements of COBRA, the requirements of FMLA, the requirements of the Health Insurance Portability and Accountability Act of 1996, the requirements of the Women's Health and Cancer Rights Act of 1998, the requirements of the Newborns' and Mothers' Health Protection Act of 1996, or any amendment to each such act, or any similar provisions of state law applicable to its Employees.

  • CEQA Compliance The District has complied with all assessment requirements imposed upon it by the California Environmental Quality Act (Public Resource Code Section 21000 et seq. (“CEQA”) in connection with the Project, and no further environmental review of the Project is necessary pursuant to CEQA before the construction of the Project may commence.

  • FEDERAL COMPLIANCE Contractor agrees to comply with all federal statutes relating to nondiscrimination, labor standards, and environmental compliance. Additionally, for work to be performed under the Agreement or subcontract thereof, including procurement of materials or leases of equipment, Contractor shall notify each potential subcontractor or supplier of the Contractor's federal compliance obligations. These may include, but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) the Fair Labor Standards Act of 1938 (29 USC 676 et. seq.), (d) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794), which prohibits discrimination on the basis of handicaps and the Americans with Disabilities Act of 1990; (e) the Age Discrimination in Employment Act of 1967 (29 USC 621 et. seq.) and the Age Discrimination Act of 1974, as amended (42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (f) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (g) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to the nondiscrimination on the basis of alcohol abuse or alcoholism; (h) §§ 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee- 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (i) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (j) any other nondiscrimination provisions in any specific statute(s) applicable to any Federal funding for this Agreement; (k) the requirements of any other nondiscrimination statute(s) which may apply to this Agreement; (l) applicable provisions of the Clean Air Act (42 X.X.X. §0000 et seq.), the Federal Water Pollution Control Act, as amended (33 X.X.X. §0000 et seq.), Section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738, and the Environmental Protection Agency regulations at 40 CPR Part 15; (m) applicable provisions of the Xxxxx- Xxxxx Act (40 U.S.C. 000x - 000x-0), xxx Xxxxxxxx Xxx (40 U.S.C. 276c), and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-332), as set forth in Department of Labor Regulations at 20 CPR 5.5a; (n) the mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (P.L. 94-163).

  • FERPA Compliance In connection with all FERPA Records that Contractor may create, receive or maintain on behalf of University pursuant to the Underlying Agreement, Contractor is designated as a University Official with a legitimate educational interest in and with respect to such FERPA Records, only to the extent to which Contractor (a) is required to create, receive or maintain FERPA Records to carry out the Underlying Agreement, and (b) understands and agrees to all of the following terms and conditions without reservation:

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