Transplant. (BadgerCare Plus and SSI Medicaid Plans) Members who have had a transplant that is considered experimental such as a liver, heart, lung, heart-lung, pancreas, pancreas-kidney or bone marrow transplant are eligible for an exemption.
a. Members who have had a transplant that is considered experimental will be permanently exempted from HMO enrollment the first of the month in which surgery is performed.
b. In the case of autologous bone marrow transplants, the person will be permanently exempted from HMO enrollment the date the bone marrow was extracted.
c. Members who have had one or more of the transplant surgeries referenced above prior to enrollment in an HMO will be permanently exempted. The effective date will be either the first of the month not more than six months prior to the date of the request, or the first of the month of the HMO enrollment, whichever is later. Exemption requests may be made by the HMO and should be directed to the Department's fiscal agent Nurse Consultant.
Transplant procedures not included in the list above, or otherwise excluded under this Contract, such as Experimental or Investigational transplant procedures.
Transplant. The transplant of human solid organs, specifically:
Transplant. 2007;7(12):2683-92. References [228] Xxxxxxxxx XX, Xx H, Xxxxxxx C, et al. Use of genetic profiling in leprosy to discriminate clinical forms of the disease. Science 2003;301(5639):1527-30. [229] Xxxxxx DE, Xxxxx N, Xxxxxxx M, et al. Leukocyte immunoglobulin-like receptors: novel innate receptors for human basophil activation and inhibition. Blood 2004;104(9):2832-9. [230] Xxxxx D, Xxxxxxx XX, Xxx XX, Xxxxxxxx K, Xxxxx T, Xxxxxxx XX. Instruction of distinct CD4 T helper cell fates by different notch ligands on antigen-presenting cells. Cell 2004;117(4):515-26. [231] Xxxxxxxx MA, Xxxxxxx R, Xxxx XX, et al. Notch ligand Delta-like 4 regulates disease pathogenesis during respiratory viral infections by modulating Th2 cytokines. X.Xxx.Xxx. 2007;204(12):2925-34.
Transplant. IRP nurses shall continue to receive on-call pay for all hours worked during assigned on- call. It is not the intent to schedule a Transplant IRP nurse in an on-call status to displace a regular staff nurse’s schedule request. A Transplant IRP nurse who signs up for an on- call shift shall not displace a regular Transplant Coordinator who signs up for the on-call shift. The scheduling of Transplant IRP nurses for on-call is at the discretion of management based on operational needs.
Transplant. (2004). doi:10.1093/ndt/gfg485.
Transplant. Replacement of solid organs; stem cells; bone marrow or tissue. • Transplant Occurrence. Considered to begin at the point of authorization for evaluation for a Transplant, and end: (1) 180 days from the date of the Transplant; or (2) upon the date the Member is discharged from the Hospital or outpatient facility for the admission or visit(s) related to the Transplant, whichever is later. • Urgent Care. Non-preventive or non-routine health care services which are Covered Benefits and are required in order to prevent serious deterioration of a Member’s health following an unforeseen illness, injury or condition if: (a) the Member is temporarily absent from the HMO Service Area and receipt of the health care service cannot be delayed until the Member returns to the HMO Service Area; or, (b) the Member is within the HMO Service Area and receipt of the health care services cannot be delayed until the Member’s Primary Care Physician is reasonably available. The Covered Benefits section of the Certificate is hereby amended to include the following provision: Benefits include only those Infertility services provided to a Member: a) by a Participating Provider to diagnose Infertility; and b) by a Participating Infertility Specialist to surgically treat the underlying medical cause of Infertility. Contract Holder Group Agreement Effective Date: January 1, 2013 The HMO Certificate of Coverage is hereby amended as follows: The Appeals of Adverse Benefit Determination provision appearing in the Claim Procedures/Complaints and Appeals section of the Certificate is hereby deleted and replaced by the following:
Transplant. 8.20.1 Fully Compliant The eMEDRenal Transplant module is included in v3.0 . All documentation for transplant work-up is captured in the purpose designed Work-up form.
8.20.2 Fully Compliant These lists are immediately visible in the Transplant management module.
8.20.3 Fully Compliant A list of patients suspended from the transplant list is maintained. The reason for the suspension, if not apparent from the selected suspension code, can be recorded in a supporting comment. A date for the review of the suspension can be entered, and this will appear in a Reminders list.
8.20.4 Fully Compliant The live work up process links the potential recipient with one or more potential donors. These links are stored as part of the patient record. All required information describing the donor and recipient are stored in eMEDRenal.
8.20.5 Fully Compliant All details of the transplant procedure can be stored in eMEDRenal. Virology details are imported via the laboratory interface. HLA and CMV mismatch details are recorded in the Procedure edit form.
8.20.6 Fully Compliant Transplant immunosuppressant induction can be recorded in the Transplant Procedure form.
8.20.7 Fully Compliant Information on the cadaveric donor, including cause of death, can be documented in conjunction with the transplant procedure record.
8.20.8 Fully Compliant The condition of the donor organ is recorded in the Transplant procedure record.
8.20.9 Fully Compliant Post transplant care is handled by a review process. This includes screening as specified by local practice or guidelines. All details are entered using a specific transplant review form. The ability to create and maintain a structured post transplant treatment pathway will be supported by the Pathway Management module which is planned for development. The design principles for the pathway management function have been documented. The software development has not yet been scheduled, but this will probably be prioritised for the second half of 2012. This functionality will be added to the product at no additional charge to all user sites with a current maintenance contract.
8.20.10 Fully Compliant These alerts are generated on demand as part of a report of outlying or changing laboratory results. The facility to request notification of lab result availability is included in the Lab Requests function, the notification is provided in an internal eMEDRenal message.
8.20.11 Fully Compliant The eMEDRenal Transplant module has been developed to b...
Transplant. This is a covered expense under this Program. This is a covered expense under this Program. This is NOT a covered expense under This Program.
