Transplant Services. Expenses for the following are excluded: a. transplant procedures excluded under this Contract (e.g., Experimental or Investigational transplant procedures); b. transplant procedures involving the transplantation or implantation of any non-human organ or tissue; c. transplant procedures related to the donation or acquisition of an organ or tissue for a recipient who is not covered by XxXxx; d. transplant procedures involving the implant of an artificial organ, including the implant of the artificial organ; e. any organ, tissue, marrow, or stem cells which is/are sold rather than donated; f. any Bone Marrow Transplant, as defined herein, which is not specifically listed in Rule 59B-12.001, Florida Administrative Code, or any successor or similar rule or covered by Medicare pursuant to a national coverage decision made by CMS as evidenced in the most recently published Medicare National Coverage Determinations Manual; g. any service in connection with the identification of a donor from a local, state or national listing, except in the case of a Bone Marrow Transplant; h. any non-medical costs, including temporary lodging or transportation costs for you or your family to and from the approved facility, except as described in Section 10.19; i. any artificial heart, mechanical device, or ventricular assist device (VAD) that replaces either the atrium or the ventricle; j. collection and storage costs associated with the banking of umbilical cord blood; k. transplant services and procedures provided by or at facilities that are not AvMed In-Network Center of Excellence facilities located within the State of Florida.
Appears in 3 contracts
Samples: Medical and Hospital Service Contract, Medical and Hospital Service Contract, Medical and Hospital Service Contract
Transplant Services. Expenses for the following are excluded:
a. transplant procedures excluded under this Contract (e.g., Experimental or Investigational transplant procedures);
b. transplant procedures involving the transplantation or implantation of any non-human organ or tissue;
c. transplant procedures related to the donation or acquisition of an organ or tissue for a recipient who is not covered by XxXxx;
d. transplant procedures involving the implant of an artificial organ, including the implant of the artificial organ;
e. any organ, tissue, marrow, or stem cells which is/are sold rather than donated;
f. any Bone Marrow Transplant, as defined herein, which is not specifically listed in Rule 59B-12.001, Florida Administrative Code, or any successor or similar rule or covered by Medicare pursuant to a national coverage decision made by CMS as evidenced in the most recently published Medicare National Coverage Determinations Manual;
g. any service in connection with the identification of a donor from a local, state or national listing, except in the case of a Bone Marrow Transplant;
h. any non-medical costs, including temporary lodging or transportation costs for you or your family to and from the approved facility, except as described in Section 10.19Part X. LIMITATIONS OF C OVERED MEDICAL SERVICES;
i. any artificial heart, mechanical device, or ventricular assist device (VAD) that replaces either the atrium or the ventricle;
j. collection and storage costs associated with the banking of umbilical cord blood;
k. transplant services and procedures provided by or at facilities that are not AvMed In-Network Center of Excellence facilities located within the State of Florida, with whom AvMed has contracted to provide transplant services as described in this Contract.
Appears in 3 contracts
Samples: Medical and Hospital Service Contract, Medical and Hospital Service Contract, Medical and Hospital Service Contract
Transplant Services. Expenses for the following are excluded:
a. transplant procedures excluded under this Contract (e.g., Experimental or Investigational transplant procedures);
b. transplant procedures involving the transplantation or implantation of any non-human organ or tissue;
c. transplant procedures related to the donation or acquisition of an organ or tissue for a recipient who is not covered by XxXxx;
d. transplant procedures involving the implant of an artificial organ, including the implant of the artificial organ;
e. any organ, tissue, marrow, or stem cells which is/are sold rather than donated;
f. any Bone Marrow Transplant, as defined herein, which is not specifically listed in Rule 59B-12.001, Florida Administrative Code, or any successor or similar rule or covered by Medicare pursuant to a national coverage decision made by CMS as evidenced in the most recently published Medicare National Coverage Determinations Manual;
g. any service in connection with the identification of a donor from a local, state or national listing, except in the case of a Bone Marrow Transplant;
h. any non-medical costs, including temporary lodging or transportation costs for you or your family to and from the approved facility, except as described in Section 10.1910.18;
i. any artificial heart, mechanical device, or ventricular assist device (VAD) that replaces either the atrium or the ventricle;
j. collection and storage costs associated with the banking of umbilical cord blood;
k. transplant services and procedures provided by or at facilities that are not AvMed In-Network Center of Excellence facilities located within the State of Florida.
Appears in 2 contracts
Samples: Medical and Hospital Service Contract, Large Group Hmo Plan Medical and Hospital Service Contract
Transplant Services. Expenses for the following are excluded:
a. transplant procedures excluded under this Contract (e.g., Experimental or Investigational transplant procedures);
b. transplant procedures involving the transplantation or implantation of any non-human organ or tissue;
c. transplant procedures related to the donation or acquisition of an organ or tissue for a recipient who is not covered by XxXxx;
d. transplant procedures involving the implant of an artificial organ, including the implant of the artificial organ;
e. any organ, tissue, marrow, or stem cells which is/are sold rather than donated;
f. any Bone Marrow Transplant, as defined herein, which is not specifically listed in Rule 59B-12.001, Florida Administrative Code, or any successor or similar rule or covered by Medicare pursuant to a national coverage decision made by CMS as evidenced in the most recently published Medicare National Coverage Determinations Manual;
g. any service in connection with the identification of a donor from a local, state or national listing, except in the case of a Bone Marrow Transplant;
h. any non-medical costs, including temporary lodging or transportation costs for you or your family to and from the approved facility, except as described in Section 10.1910.20;
i. any artificial heart, mechanical device, or ventricular assist device (VAD) that replaces either the atrium or the ventricle;
j. collection and storage costs associated with the banking of umbilical cord blood;
k. transplant services and procedures provided by or at facilities that are not AvMed In-Network Center of Excellence facilities located within the State of Florida.
Appears in 2 contracts
Samples: Large Group Choice Plan Medical and Hospital Service Contract, Medical and Hospital Service Contract
Transplant Services. Expenses for the following are excluded:
a. transplant procedures excluded under this Contract (e.g., Experimental or Investigational transplant procedures);
b. transplant procedures involving the transplantation or implantation of any non-human organ or tissue;
c. transplant procedures related to the donation or acquisition of an organ or tissue for a recipient who is not covered by XxXxx;
d. transplant procedures involving the implant of an artificial organ, including the implant of the artificial organ;
e. any organ, tissue, marrow, or stem cells which is/are sold rather than donated;
f. any Bone Marrow Transplant, as defined herein, which is not specifically listed in Rule 59B-12.001, Florida Administrative Code, or any successor or similar rule or covered by Medicare pursuant to a national coverage decision made by CMS as evidenced in the most recently published Medicare National Coverage Determinations Manual;
g. any service in connection with the identification of a donor from a local, state or national listing, except in the case of a Bone Marrow Transplant;
h. any non-medical costs, including temporary lodging or transportation costs for you or your family to and from the approved facility, except as described in Section 10.19Part X. LIMITATIONS OF C OVERED MEDICAL SERVICES;
i. any artificial heart, mechanical device, or ventricular assist device (VAD) that replaces either the atrium or the ventricle;
j. collection and storage costs associated with the banking of umbilical cord blood;
k. transplant services and procedures provided by or at facilities that are not AvMed In-Network Center of Excellence facilities located within the State of Florida.
Appears in 2 contracts
Samples: Medical and Hospital Service Contract, Medical and Hospital Service Contract
Transplant Services. Expenses for the following are excluded:
a. transplant procedures excluded under this Contract (e.g., Experimental or Investigational transplant procedures);
b. transplant procedures involving the transplantation or implantation of any non-human organ or tissue;
c. transplant procedures related to the donation or acquisition of an organ or tissue for a recipient who is not covered by XxXxx;
d. transplant procedures involving the implant of an artificial organ, including the implant of the artificial organ;
e. any organ, tissue, marrow, or stem cells which is/are sold rather than donated;
f. any Bone Marrow Transplant, as defined herein, which is not specifically listed in Rule 59B-12.001, Florida Administrative Code, or any successor or similar rule or covered by Medicare pursuant to a national coverage decision made by CMS as evidenced in the most recently published Medicare National Coverage Determinations Manual;
g. any service in connection with the identification of a donor from a local, state or national listing, except in the case of a Bone Marrow Transplant;
h. any non-medical costs, including temporary lodging or transportation costs for you or your family to and from the approved facility, ; except as described in Section 10.1910.20;
i. any artificial heart, mechanical device, or ventricular assist device (VAD) that replaces either the atrium or the ventricle;.
j. collection and storage costs associated with the banking of umbilical cord blood;.
k. transplant services and procedures provided by or at facilities that are not AvMed In-Network Center of Excellence facilities located within the State of Florida.
Appears in 1 contract
Transplant Services. Expenses for the following are excluded:
a. transplant procedures excluded under this Contract (e.g., Experimental or Investigational transplant procedures);
b. transplant procedures involving the transplantation or implantation of any non-human organ or tissue;
c. transplant procedures related to the donation or acquisition of an organ or tissue for a recipient who is not covered by XxXxx;
d. transplant procedures involving the implant of an artificial organ, including the implant of the artificial organ;
e. any organ, tissue, marrow, or stem cells which is/are sold rather than donated;
f. any Bone Marrow Transplant, as defined herein, which is not specifically listed in Rule 59B-12.001, Florida Administrative Code, or any successor or similar rule or covered by Medicare pursuant to a national coverage decision made by CMS as evidenced in the most recently published Medicare National Coverage Determinations Manual;
g. any service in connection with the identification of a donor from a local, state or national listing, except in the case of a Bone Marrow Transplant;
h. any non-medical costs, including temporary lodging or transportation costs for you or your family to and from the approved facility, except as described in Section 10.1910.20;
i. any artificial heart, mechanical device, or ventricular assist device (VAD) that replaces either the atrium or the ventricle;
j. collection and storage costs associated with the banking of umbilical cord blood;.
k. transplant services and procedures provided by or at facilities that are not AvMed In-Network Center of Excellence facilities located within the State of Florida.
Appears in 1 contract