Experimental services definition
Examples of Experimental services in a sentence
Experimental services that are Covered Services per the definition above shall have the financial responsibility described in the DFR.
The following includes but is not limited to a general list of the services not covered by the FFS program: • Services or supplies that are not medically necessary • Treatment of obesity unless medically necessary • Experimental services and procedures, including drugs and equipment, not covered by Medicaid, and not in accordance with customary standards of practice.
The following is a general list of the services not covered by the Ohio Medicaid fee-for-service program: • Services or supplies that are not medically necessary • Experimental services and procedures, including drugs and equipment, not covered by Medicaid • Organ transplants that are not covered by Medicaid • Abortions, except in the case of a reported rape.
The following services are excluded from coverage to Medicare Enrollees pursuant to CMS: Experimental services, private duty nurses, convenience items, full-time in-home nursing care, homemaker services, elective or voluntary enhancement procedures, cosmetic surgery, routine chiropractic, dental, and foot care, routine eye exams/glasses, RK & LASIK surgery, and vision therapy.
However, as specified in AMPM Policy 320-B, the Contractor has responsibilities related to Experimental services and Qualifying Clinical Trials.
Experimental services or services generally regarded by the medical profession as unacceptable treatment are not medically necessary for purposes of this contract.