In the enrollment form Plaintiff certified that she carefully read and agreed to abide by the provisions of the Group Health Agreement, Certificate of Coverage and Benefit Riders under which she enrolled.
Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.
Home health aide means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.
Group health benefit plan means any health care plan, subscription contract, evidence of
Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.
Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:
State health plan means the employee and retiree insurance program provided for in Article 5, Chapter 11, Title 1.
Home health agency means a person certified by medicare whose business is to provide to individuals in their places of residence other than in a hospital, nursing home, or county medical care facility 1 or more of the following services: nursing services, therapeutic services, social work services, homemaker services, home health aide services, or other related services.
Rural health clinic means a rural health clinic as defined under section 1861 of part C of title XVIII of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1395x, and certified to participate in medicaid and medicare.
Behavioral health administration or "BHA" means
Ontario Health means the corporation without share capital under the name Ontario Health as continued under the CCA;
Federal Health Care Program means any “federal health care program” as defined in 42 U.S.C. § 1320a-7b(f), including Medicare, state Medicaid programs, state CHIP programs, the Veterans Administration, TRICARE and similar or successor programs with or for the benefit of any Governmental Authority, and in each case any third party payor administering such programs.
Indian Health Care Provider means a health care program operated by the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian Organization (otherwise known as an I/T/U) as those terms are defined in § 4 of the Indian Health Care Improvement Act (25 USC § 1603). Indian Health Care Provider includes a 638 Facility and provision of Indian Health Service Contract Health Services (IHS CHS).
Home Health Care means the continual care and treatment of an individual if:
Behavioral health treatment means counseling and treatment programs, including applied behavior analysis, that are:
Medical home means a team approach to providing health care that originates in a primary care setting; fosters a partnership among the patient, the personal provider, and other health care professionals, and where appropriate, the patient’s family; utilizes the partnership to access and integrate all medical and nonmedical health-related services across all elements of the health care system and the patient’s community as needed by the patient and the patient’s family to achieve maximum health potential; maintains a centralized, comprehensive record of all health-related services to promote continuity of care; and has all of the characteristics specified in section 135.158.
Basic health plan means the plan described under chapter
Health Agency means the California Department of Health Services, or the local health officer with respect to a small water system.
Home health services means part-time or intermittent skilled nursing services, other therapeutic services (physical therapy, occupational therapy, speech therapy), and home health aide services made available on a visiting basis in a place of residence used as the client's home.
Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.
Behavioral health services means mental health services as
Department of Health and Human Services means the Department of Health and Human Services
Group home means a facility for housing youth and is licensed by Community Care 16 Licensing under the provisions of CCR, Title 22, Division 6, et seq.
School health services means health services provided by a qualified school nurse or other qualified person that are designed to enable a child with a disability to receive FAPE as described in the child’s IEP.
Health Home means an individual Provider, team of health care professionals or health team that meets all federal requirements and provides the following six (6) services to persons with one (1) or more specified chronic conditions: (i) comprehensive care management; (ii) Care Coordination and health promotion; (iii) comprehensive transitional care/follow-up; (iv) Member and family support; (v) referral to community and social support services; and (vi) use of Health Information Technology (HIT) to link services, if applicable. Health Information Exchange (HIE) means the transmission of health-care-related data among facilities, health information organizations and government agencies according to national standards. HIE is also an entity that provides services to enable the electronic sharing of health information. Health Information Technology (HIT) means the area of information technology involving the design, development, creation, use and maintenance of information systems for the health care industry.
Health history means the record of a person’s past health events obtained in writing, completed by the individual or their physician.
Mental health services means interventions designed to provide the maximum reduction of mental disability and restoration or maintenance of functioning consistent with the requirements for learning, development and enhanced self-sufficiency. Services shall include: a. Assessment means a service activity, which may include a clinical analysis of the history and current status of a beneficiary’s mental, emotional, or behavioral disorder, relevant cultural issues and history, Diagnosis and the use of testing procedures.