NMAC Sample Clauses

NMAC. Current patients are covered persons who have a claim with Presbyterian Health Plan (PHP) related to the provider's services within the past year, or who have received a pre-authorization prior to termination to use the provider's services at a future time. PHP will assist such affected covered persons in locating and transferring to another similarly qualified provider. A covered person may not be held financially liable for services received from the provider in good faith between the effective date of the suspension or termination and the receipt of notice provided to the covered person, if the covered person has not received comparable notice during this time from the provider. Out-of-network (outside of the 5-county area) Practitioners/Providers are healthcare Practitioners/Providers, including non-medical facilities, who have not entered into an agreement with us to provide Healthcare Services to PHP Members on this plan. Covered Healthcare Services obtained from an Out-of-network (outside of the 5-county area) Practitioner/Provider or outside the Service Area will not be Covered unless such services are not reasonably available from an In-network Practitioner/Provider or in cases of urgent or an emergency. You will not pay higher or additional Cost Sharing amounts under such circumstances. These provisions also apply to Telehealth services. If you pay a non-participating Provider more than the in-network cost-sharing amount for services provided under circumstances giving rise to a surprise bill, the non-participating Provider must refund to you within 45 days of receipt of payment from Presbyterian any amount paid in excess of the in-network cost-sharing amount. In accordance with the hearing procedures established pursuant to the Patient Protection Act [Chapter 59, Article 57 NMSA 1978], you may appeal Presbyterian’s determination made regarding a surprise bill. Services provided by an Out-of-network (outside of the 5-county area) Practitioner/Provider, except for urgent or Emergency services, require that your Primary Care Physician request and obtain written approval (Authorization) from our Medical Director BEFORE services are rendered. Otherwise, you may be responsible for payment. Please refer to the Prior Authorization Section for more information on Prior Authorization requirements. If the services of an Out-of-network (outside of the 5-county area) Practitioner/Provider are required, your In-network Practitioner/Provider must request and o...
NMAC. We understand that we must retain or hire a Licensed School Business Manager as soon as financial feasible and, thereafter, notify the New Mexico Public Education Commission within 30 days of hiring and/or changing in a Licensed School Business Manager for the school, and a new, signed “Affidavit of Financial Custodian” must be submitted. We understand that we must submit an Affidavit of Governing Body Member to the Public Education Commission within 60 days of a change in membership of our governing body. THE FOLLOWING MEMBERS OF THE XXX XXXXX CHARTER HIGH SCHOOL GIVE THE FOREGOING STATEMENT THIS 18th DAY OF JANURARY, 2022.
NMAC. All personal identifiers shall be redacted and not disclosed publicly by the CSD or the Commission unless compelled to do so.
NMAC. The Lessee shall continue to comply with the existing mine development plan until the Commissioner approves the modification. The Commissioner may refuse to approve any modification that the Commissioner determines is not in the best interest of the trust.
NMAC. The PROVIDER may not employ any person who has been excluded from the Medicare or Medicaid Program.
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NMAC. Pre-NMAC History: The material in this part was derived from that previously filed with the State Records Center and Archives under:
NMAC. The determination shall be made in compliance with all applicable requirements of 34 CFR Sec. 300.306. (b) The public agency must provide a copy of the evaluation report and the documentation of determination of eligibility to the parent.
NMAC. We understand that we must retain or hire a Licensed School Business Manager as soon as financial feasible and, thereafter, notify the New Mexico Public Education Commission within 30 days of hiring and/or changing in a Licensed School Business Manager for the school, and a new, signed “Affidavit of Financial Custodian” must be submitted. We understand that we must submit an Affidavit of Governing Body Member to the Public Education Commission within 30 days of a change in membership of our governing body. THE FOLLOWING MEMBERS OF THE Explore Academy - Las Cruces’s Governing Board GIVE THE FOREGOING STATEMENT THIS 13th DAY OF April, 2022.
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