Substance Abuse Residential Treatment Center. A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board. A general Hospital facility that provides services, on an inpatient, 24-hour basis, for medical Detoxification and treatment of conditions associated with the addiction to or misuse of alcohol or other drugs. Technology Assessment Criteria Five criteria all procedures must meet in order to be Covered Services under this Contract. • The technology must have final approval from the appropriate government regulatory bodies. • The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes. • The technology must improve the net health outcome. • The technology must be as beneficial as any established alternative. • The technology must be beneficial in practice. Telehealth means the use of information and communication technologies, including, but not limited to, telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health related education, public health, and health administration. Telemedicine is a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self- management of a patient’s health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in this state, while such patient is at an originating site and the health care provider is at a distant site.
Substance Abuse Residential Treatment Center. A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board. A general Hospital facility that provides services, on an inpatient, 24-hour basis, for medical Detoxification and treatment of conditions associated with the addiction to or misuse of alcohol or other drugs. Five criteria all procedures must meet in order to be Covered Services under this Contract. • The technology must have final approval from the appropriate government regulatory bodies. • The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes. • The technology must improve the net health outcome. • The technology must be as beneficial as any established alternative. • The technology must be beneficial in practice. A health care service, other than a telemedicine service, delivered by a licensed or certified health professional, acting within the scope of the healthcare professional’s license or certification, who does not perform Telemedicine, that requires the use of advanced telecommunications technology, other than by telephone or facsimile including: • Compressed digital interactive video, audio, or data transmission; • Clinical data transmission using computer imaging by way of still-image capture; and • Other technology that facilitates access to healthcare services or medical specialty expertise.
Substance Abuse Residential Treatment Center. A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board. A general Hospital facility that provides services, on an inpatient, 24-hour basis, for medical Detoxification and treatment of conditions associated with the addiction to or misuse of alcohol or other drugs. Five criteria all procedures must meet in order to be Covered Services under this Contract. • The technology must have final approval from the appropriate government regulatory bodies. • The scientific evidence must permit conclusions concerning the effect of the technology onhealth outcomes. • The technology must improve the net health outcome. • The technology must be as beneficial as any established alternative. • The technology must be beneficial in practice. Telehealth means the use of information and communication technologies, including, but not limited to, telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health related education, public health, and health administration. Telemedicine is a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of Therapeutic/Clinically Equivalent Certain Prescription Drugs may not be covered when clinically equivalent alternatives are available, unless otherwise required by law. “Therapeutic/Clinically Equivalent” means Drugs that, for the majority of Members, can be expected to produce similar therapeutic outcomes for a disease or condition. Therapeutic/Clinically Equivalent determinations are based on industry standards and reviewed by such organizations as The Agency for Healthcare Research and Quality (AHRQ), a division of the U.S. Department of Health and Human Services.
Substance Abuse Residential Treatment Center. A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board. Technology Assessment Criteria Five criteria all procedures must meet in order to be Covered Services under this Contract. • The technology must have final approval from the appropriate government regulatory bodies. • The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes. • The technology must improve the net health outcome. • The technology must be as beneficial as any established alternative. • The technology must be beneficial inpractice. Telehealth Services Telehealth means the use of information and communications technologies, including, but not limited to, telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health related education, public health, and health administration. Telemedicine is a form of telehealth which is the delivery of clinical health care services by means of real time two- way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self- management of a patient's health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in this state, while such patient is at an originating site and the health care provider is at a distant site. Neither a telephone conversation nor an electronic mail message between a healthcare practitioner and a patient is telemedicine. Therapeutic/Clinically Equivalent
