Experimental and/or Investigational definition

Experimental and/or Investigational means services, supplies, care and treatment which do not constitute accepted Medical practice properly within the range of appropriate Medical practice under the standards of the case and by the standards of a reasonably substantial, qualified, responsible, relevant segment of the Medical community or government oversight agencies at the time services were rendered. The Plan Administrator and/or Claims Administrator must make an independent evaluation of the Experimental/non-Experimental standings of specific technologies. The Plan Administrator and/or Claims Administrator shall be guided by a reasonable interpretation of Plan provisions. The decisions shall be made in good faith and rendered following a detailed factual background investigation of the Claim and the proposed treatment. The decision of the Plan Administrator and/or Claims Administrator will be final and binding on the Plan. The Plan Administrator and/or Claims Administrator will be guided by the following principles: a) if the drug or device cannot be lawfully marketed without approval of the U.S. Food and Drug Administration (FDA) and approval for marketing has not been given at the time the drug or device is furnished; b) if the drug, device, Medical treatment or procedure, or the patient informed consent document utilized with the drug, device, treatment or procedure, was reviewed and approved by the treating facility's Institutional Review Board or other body serving a similar function, or if federal law requires such review or approval; c) if reliable evidence shows that the drug, device, Medical treatment or procedure is the subject of on-going phase I or phase II clinical trials (is the research, Experimental study or Investigational arm of on-going phase III clinical trials, or is it otherwise under study to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment or Diagnosis); or d) if reliable evidence shows that the prevailing opinion among experts regarding the drug, device, Medical treatment or procedure is that further studies or clinical trials are necessary to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment or Diagnosis.Reliable evidence shall mean only published reports and articles in the authoritative Medical and scientific literature; the written protocol or protocols used by the treating facility...
Sample 1Sample 2
Experimental and/or Investigational means a drug, treatment, device, surgery or procedure that AvMed, in its discretion, determines to be Experimental and/or Investigational if any of the following applies:
Sample 1Sample 2
Experimental and/or Investigational means a Treatment which does not constitute accepted medical practice within the standards of a qualified relevant segment of the United States of America medical community or the U.S. federal government oversight agencies at the time services were rendered.
Sample 1

Examples of Experimental and/or Investigational in a sentence

  • Experimental and/or Investigational: Any treatment, procedure, technology, facility, equipment, medication, medication usage, device, or supplies not recognized as accepted medical practice by Insurer.

  • Not Covered Under this BenefitCertain treatments and medications, such as vitamins, herbs, aspirin, cold remedies, medicines, Experimental and/or Investigational medications, or supplies, even when recommended by a Physician, do not qualify as Prescription Medications.

  • Also, you will be subject to additional requirements for an External Review regarding Experimental and/or Investigational Services.

  • Expenses for treatment, procedures, devices, drugs or medicines which are determined to be Experimental and/or Investigational will not be considered eligible, except for Off- Label Drug Use or when such expenses are considered Qualified Clinical Trial Expenses.

  • Experimental and/or Investigational means services, supplies, care and Treatment which do not constitute accepted medical practice properly within the range of appropriate medical practice under the standards of the case and by the standards of a reasonably substantial, qualified, responsible, relevant segment of the medical community or government oversight agencies at the time services were rendered.

  • Experimental and/or Investigational (continued)In determining coverage under this Plan, the Plan Administrator and the Third Party Administrator shall make an independent evaluation of the experimental status of specific technologies and shall be guided by a reasonable interpretation of Plan provisions.

  • The Plan Administrator retains maximum legal authority and discretion to determine what is Experimental and/or Investigational.

  • MEDICAL BENEFITS All benefits described in this Schedule are subject to the exclusions and limitations described more fully herein including, but not limited to, the Plan Administrator's determination that: care and treatment is Medically Necessary; that charges are Usual and Reasonable; that services, supplies and care are not Experimental and/or Investigational.

  • Transplants which are not medically recognized and are Experimental and/or Investigational in nature.

  • Except for Approved Clinical Trials, Experimental and/or Investigational Services are not covered.


More Definitions of Experimental and/or Investigational

Experimental and/or Investigational means services, supplies, care and treatment which does not constitute accepted medical practice properly within the range of appropriate medical practice under the standards of the case and by the standards of a reasonably substantial, qualified, responsible, relevant segment of the medical community or government oversight agencies at the time services were rendered.The Claims Administrator shall obtain an independent evaluation of the Experimental/non-Experimental standings of specific technologies.The Experimental and/or Investigational procedure is any medical or surgical procedure, treatment, course of treatment, equipment, drug or medicine:
Sample 1

Related to Experimental and/or Investigational

  • EXPERIMENTAL OR INVESTIGATIONAL means any healthcare service that has progressed to limited human application, but has not been recognized as proven and effective in clinical medicine. See Experimental or Investigational Services in Section 3 for a more detailed description of the type of healthcare services we consider experimental or investigational.

  • Investigational Product means the Study Drug identified above and the control material, as further detailed in the Protocol;

  • Complaint Investigation means an investigation of any complaint that has been made to a proper authority that is not covered by an abuse investigation.

  • clinical investigation means any systematic investigation in one or more human subjects, undertaken to assess the safety or performance of a device;

  • Background investigation means the investigation conducted by a licensee or applicant to support the determination of trustworthiness and reliability.

  • Experimental or Investigative means treatments, devices or prescription medications which are recommended by a Physician, but are not considered by the medical community as a whole to be safe and effective for the condition for which the treatments, devices or prescription medications are being used. This includes any treatments, procedures, facilities, equipment, drugs, drug usage, devices, or supplies not recognized as accepted medical practice, and any of those items requiring federal or other governmental agency approval not received at the time services are rendered.

  • Experimental means a service, procedure, item or treatment that is “not proven and effective” for the conditions for which it is intended to be used.

  • Remedial investigation means a process to determine the nature and extent of a discharge of a contaminant at a site or a discharge of a contaminant that has migrated or is migrating from the site and the problems presented by a discharge, and may include data collected, site characterization, sampling, monitoring, and the gathering of any other sufficient and relevant information necessary to determine the necessity for remedial action and to support the evaluation of remedial actions if necessary;

  • Investigations The Xxxxxxx, when requested by one or a number of employees whom he/she represents, may investigate the basis for any dispute arising under this Agreement and may, at any stage, assist the employee(s) in seeking resolution of such dispute through the grievance procedure provided herein. A representative of the Union may substitute in place of the Xxxxxxx.

  • Studies means activities needed to prepare project implementation, such as preparatory, mapping, feasibility, evaluation, testing and validation studies, including in the form of software, and any other technical support measure, including prior action to define and develop a project and decide on its financing, such as reconnaissance of the sites concerned and preparation of the financial package;

  • Microbusiness means a licensee that may act as a cannabis

  • Investigation means the Bureau’s decision to hold and not process the Company’s license renewal applications identified in Appendix A due to the Company’s inability to certify compliance with its public file obligations.

  • Study means the investigation to be conducted in accordance with the Protocol.

  • Clinical means having a significant relationship, whether real or potential, direct or indirect, to the actual rendering or outcome of dental care, the practice of dentistry, or the quality of dental care being rendered to a patient;

  • Friable asbestos material means any material that contains more than 1% asbestos by weight and that can be crumbled, pulverized, or reduced to powder when dry, by hand pressure.

  • Investigational Medicinal Product means the study drug or control material as defined in the Protocol.

  • Sampling means the distribution of samples to members of the general public in a public place.

  • Current significant investigative information means investigative information that a licensing board, after an inquiry or investigation that includes notification and an opportunity for the audiologist or speech-language pathologist to respond, if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction.

  • experimental development means acquiring, combining, shaping and using existing scientific, technological, business and other relevant knowledge and skills with the aim of developing new or improved products, processes or services. This may also include, for example, activities aiming at the conceptual definition, planning and documentation of new products, processes or services;

  • Field means [***].

  • Commercial cannabis activity means the production, cultivation,

  • Screening means the evaluation process used to identify an individual's ability to perform activities of daily living and address health and safety concerns.

  • Environmental Activities means the use, generation, transportation, handling, discharge, production, treatment, storage, release or disposal of any Hazardous Materials at any time to or from any portion of the Premises or located on or present on or under any portion of the Premises.

  • Study Materials means all the materials and information created for the Study, or required to be submitted to the Sponsor including all data, results, Biological Samples, Case Report Forms (or their equivalent) in whatever form held, conclusions, discoveries, inventions, know-how and the like, whether patentable or not, relating to the Study, which are discovered or developed as a result of the Study, but excluding the Institution’s ordinary patient records.

  • Investigators means those persons authorised, appointed, consulted or approached by the Chairman of the Audit Committee and includes the Auditors of the Company and the Police.

  • Processes with Significant Environmental Aspects means the Equipment which, during regular operation or if not properly operated or maintained, may cause or are likely to cause an adverse effect.