Substance Use Disorder Treatment Sample Clauses

Substance Use Disorder Treatment. This agreement covers medically necessary services for the treatment of substance use disorder in a hospital, substance use disorder treatment facility, or an acute substance use disorder rehabilitation/residential facility that is: • 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 hospital, a substance use disorder treatment facility, or an acute substance use disorder residential/rehabilitative facility. We review network and non-network programs, hospital or inpatient facilities, acute substance use disorder rehabilitation/residential facilities and the specific services provided. We decide whether a program, hospital or inpatient facility, acute substance use disorder rehabilitation/residential facility, or specific services rendered meets our program requirements, content and criteria. If our program requirements, content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below.
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Substance Use Disorder Treatment. This agreement covers medically necessary services for the treatment of substance use disorder in a hospital, substance use disorder treatment facility, or an acute substance use disorder rehabilitation/residential facility that is.  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 hospital, a substance use disorder treatment facility, or an acute substance use disorder residential/rehabilitative facility. We review network and non-network programs, hospital or inpatient facilities, acute substance use disorder rehabilitation/residential facilities and the specific services provided. We decide whether a program, hospital or inpatient facility, acute substance use disorder rehabilitation/residential facility, or specific services rendered meets our program requirements, content and criteria. If our program requirements, content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below. Inpatient Hospital If you are an acute inpatient in a general or specialty hospital for behavioral health services, we cover medically necessary acute hospital services for detoxification. See Section 3.21 - Inpatient Hospital Services for additional information. Preauthorization is recommended.
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Substance Use Disorder Treatment. Obtain a substance use disorder evaluation from a Washington state-certified agency and file written proof of the evaluation with Probation Services within 90 days of entering into this Agreement. Defendant shall also successfully comply with all treatment recommendations and file written proof of such compliance through completion with Probation Services at least quarterly (every 3 months).
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Substance Use Disorder Treatment. If clinically indicated, the Care Coordinator may refer the individual to a DBHR-licensed SUD treatment program. The Care Coordinator shall use a LRA/AOT referral form, as provided by DBHR.
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Substance Use Disorder Treatment. Rehabilitative services of diagnostic evaluation and face-to-face individual or group counseling using therapeutic techniques that are provided in certified programs.
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Substance Use Disorder Treatment. If clinically indicated, the HARPS Team may refer the individual to a DBHR-licensed SUD treatment program. The HARPS Team shall use an LRA/AOT referral form, as provided by DBHR.
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Substance Use Disorder Treatment. Sharp Health Plan covers Medically Necessary services for the diagnosis or treatment of Substance Use Disorders that fall under any of the diagnostic categories listed in the mental and behavioral disorders chapter of the most recent edition of the International Classification of Diseases or that are listed in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, which include but are not limited to the following services: • Physician services, including consultation and referral to other health care providers and prescription drugs when furnished or administered by a health care provider or facility • Outpatient professional services, including but not limited to individual, group and family substance use counseling • Medication management • Diagnostic laboratory and diagnostic and therapeutic radiologic services • Drug testing, both presumptive and definitive, including for initial and ongoing patient assessment during Substance Use Disorder treatment • Home health services • Intensive home-based treatment • Preventive health services, as described under Preventive Care Services • Emergency health care services, including ambulance and ambulance transport services and Out-of-Area coverage, as described under Emergency Services and Care.
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Substance Use Disorder Treatment. Any court ordered treatment or therapy, or any treatment or therapy ordered as a condition of parole, probation, custody, or What Is Not Covered?‌‌ visitation is not covered unless determined to be Medically Necessary for diagnosis or treatment of a Substance Use Disorder. This does not apply to services received as part of a Community Assistance Recovery and Empowerment (CARE) Agreement or CARE Plan approved by a court. Any services provided to you by an Employee Assistance Program (EAP) offered by an employer are not Covered Benefits. Sharp Health Plan does not provide EAP services. Services for conditions that the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) identifies as something other than a mental health condition or Substance Use Disorder are not covered. Changes in terminology, organization, or classification of Mental Health and Substance Use Disorders in future versions of the DSM or ICD shall not affect the conditions covered by the Plan as long as a condition is commonly understood to be a Mental Health or Substance Use Disorder by health care providers practicing in relevant clinical specialties. Benefits or coverage for Medically Necessary services shall not be limited or excluded on the basis that those services should be covered by a public entitlement program, including, but not limited to, special education or an individualized education program, Medicaid, Medicare, Supplemental Security Income, or Social Security Disability Insurance. Vision services are not covered unless specifically listed as covered in this Member Handbook. Vision services that are specifically not covered for Members age 19 and older include, but are not limited to: • Eye surgery for the sole purpose of correcting refractive error (e.g., radial keratotomy). • Orthoptic services (a technique of eye exercises designed to correct the visual axes of eyes not properly coordinated for binocular vision). • Eyeglasses or contact lenses (for adults 19 and older). • Routine vision examinations (for adults 19 and older). • Eye refractions for the fitting of glasses. • Cosmetic materials, including anti- reflective coating, color coating, mirror coating, blended lenses, cosmetic lenses, laminated lenses, oversize lenses, photochromic lenses, tinted lenses (except Pink #1 and Pink #2), and progressive multifocal lenses. • Plano lenses (less than ± .50 d...
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Related to Substance Use Disorder Treatment

  • 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).

  • 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 Cardiac Rehabilitation Outpatient - Benefit is limited to 18 weeks or 36 visits (whichever occurs first) per coveredepisode. 0% - After deductible 40% - After deductible Chiropractic Services In a physician's office - limited to 12 visits per plan year. 0% - After deductible 40% - After deductible Dental Services - Accidental Injury (Emergency) 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 Dental Services- Outpatient Services connected to dental care when performed in an outpatient facility * 0% - After deductible 40% - After deductible Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Dental Care (Pediatric) - for members under age 19 See Dental Services in Section 3 for benefit limits and details. These services only apply to an enrolled member under the age of 19. Oral evaluations 0% - After deductible 0% - After deductible X-rays 0% - After deductible 0% - After deductible Cleanings (prophylaxis) 0% - After deductible 0% - After deductible Fluoride treatments 0% - After deductible 0% - After deductible Sealants 0% - After deductible 0% - After deductible Space Maintainers 0% - After deductible 0% - After deductible Palliative treatment 50% - After deductible 50% - After deductible Fillings 50% - After deductible 50% - After deductible Simple extractions 50% - After deductible 50% - After deductible Denture repairs and relines/rebasing 50% - After deductible 50% - After deductible Crowns & onlays 50% - After deductible 50% - After deductible Therapeutic Pulpotomies 50% - After deductible 50% - After deductible Root canal therapy 50% - After deductible 50% - After deductible Non-surgical periodontal services 50% - After deductible 50% - After deductible Surgical periodontal services 50% - After deductible 50% - After deductible Periodontal maintenance 50% - After deductible 50% - After deductible Fixed bridges and dentures 50% - After deductible 50% - After deductible Implants 50% - After deductible 50% - After deductible Oral surgery services 50% - After deductible 50% - After deductible General anesthesia or IV sedation - dental office 50% - After deductible 50% - After deductible Biopsies 50% - After deductible 50% - After deductible Occlusal (night) guards 50% - After deductible 50% - After deductible Orthodontic services (braces) - when medically necessary. 50% - After deductible 50% - After deductible Dialysis Services Inpatient/outpatient/in your home 0% - After deductible 40% - After deductible

  • Substance Use Disorder counseling shall be provided by a QCC, or Chemical Dependency Counselor Intern. Substance use disorder education and life skills training shall be provided by counselors or individuals who have been trained in the education. All counselor interns shall work under the direct supervision of a QCC.

  • 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.

  • 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 POLICY SECTION 1. Labor and Management are committed to providing employees with a drug-free and alcohol-free workplace. It is the goal to protect the health and safety of employees and to promote a productive workplace, and protect the reputation of Labor and Management and the employees.

  • 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.

  • Medication Assisted Treatment This plan covers medication assisted treatment for substance use disorders, including methadone maintenance treatment. Please see the Summary of Medical Benefits for specific copayments for these services.

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