Review Panel means a panel responsible for determining whether a reasonable basis exists for finding a violation of BSEF Rules, and for authorizing the issuance of notices of chargers against Persons alleged to have committed violations if the Review Panel believes that the matter should be adjudicated.
Utilization review plan or "plan" means a written procedure for performing review.
Architectural Review Committee or “ARC” shall mean the architectural review committee established by the Organization to review plans submitted to the Organization for architectural review.
Appeal Panel means a panel comprised of a chair and two individuals appointed by the Board to consider appeals under Chapter 7.
Peer review committee means one or more persons acting in a peer review capacity who also serve as an officer, director, trustee, agent, or member of any of the following:
Utilization review organization means an entity that conducts utilization review, other than a health carrier performing a review for its own health plans.
Review Package A package of documents consisting of a memorandum outlining the analysis and recommendation (in accordance with the Servicing Standard) of the Master Servicer or the Special Servicer, as the case may be, with respect to the matters that are the subject thereof, and copies of all relevant documentation.
Clinical review criteria means the written screening procedures, decision abstracts, clinical protocols, and practice guidelines used by a health carrier to determine the necessity and appropriateness of health care services.
MCO means an organization having a certificate of authority or certificate of registration from the 11 Washington State Office of Insurance Commissioner that contracts with HCA under a comprehensive 12 risk contract to provide prepaid health care services to eligible HCA Enrollees under HCA managed 13 care programs.
Application Review Start Date means the later date of either the date on which the District issues its written notice that the Applicant has submitted a completed Application or the date on which the Comptroller issues its written notice that the Applicant has submitted a completed Application and as further identified in Section 2.3.A of this Agreement.
DSX Panel means a cross connect bay or panel used for the termination of equipment and facilities operating at digital rates.
independent review committee means the independent review committee of the investment fund established under National Instrument 81-107 Independent Review Committee for Investment Funds;
Utilization review means the prospective (prior to), concurrent (during) or retrospective (after) review of any service to determine whether such service was properly authorized, constitutes a medically necessary service for purposes of benefit payment, and is a covered healthcare service under this plan. WE, US, and OUR means Blue Cross & Blue Shield of Rhode Island. WE, US, or OUR will have the same meaning whether italicized or not. YOU and YOUR means the subscriber or member enrolled for coverage under this agreement. YOU and YOUR will have the same meaning whether italicized or not.
Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).
HMO a health maintenance organization doing business as such (or required to qualify or to be licensed as such) under HMO Regulations.
HHSC means the Texas Health and Human Services Commission. “Health and Human Services” or “HHS” includes HHSC and DSHS.
Benchmark Review means a review of the Services carried out in accordance with paragraphs 2.1 to 2.3 of Schedule 7 (Value for Money) of this Framework Agreement to determine whether those Services represent Good Value;
Architectural Control Committee means and refer to that committee constituted under Article 4 hereof for the review of Development Plans (as hereinafter defined) and other functions.
Managed care plan means a health benefit plan that either requires a covered person to use, or
Search Committee means the Search Committee set up by the Senate under section 15 (2);
Procurement Committee means a Committee constituted by the Employer to perform the functions as such under the terms and conditions of Contract.
layout plan means a plan of the project depicting the division or proposed division of land into plots, roads, open spaces, amenities, etc. and other details as may be necessary;
Medical Review Officer (MRO) means a licensed physician responsible for receiving and reviewing laboratory results generated by the school district’s drug testing program and for evaluating medical explanations for certain drug tests.
ODJFS means the Ohio Department of Job and Family Services.
Appeals Panel means a panel appointed by the Chief Compliance Officer pursuant to Rule 620.
Review Committee or “Committee” means a committee established pursuant to rule Chapter 67-60, F.A.C.