Nonquantitative treatment limitations definition

Nonquantitative treatment limitations means limitations that are not expressed numerically, but otherwise limit the scope or duration of benefits for treatment.
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Nonquantitative treatment limitations means limitations that are not expressed numerically, but otherwise limit the scope or duration of benefits for treatment, as expressed at 45 CFR 146.136(c)(4)(ii).
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Nonquantitative treatment limitations means those limitations that are not expressed numerically but otherwise limit the scope or duration of benefits for treatment under a health insurance policy or coverage and includes, but is not limited to, the limitations described under 45 CFR 146.136. Nonquantitative treatment limitations do not include a complete exclusion of all benefits for a certain condition or disorder.
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Examples of Nonquantitative treatment limitations in a sentence

  • Non-quantitative treatment limitations can be any “non-numerical limitations on the scope or duration of” treatment.24 Common non-quantitative treatment limitations include “priorauthorization” requirements.

  • The rule requires parity in the following key areas: • Aggregate lifetime and annual dollar limits (AL/ADLs).• Financial requirements (FRs—such as copays).• Quantitative treatment limitations (QTLs—such as day and visit limits).• Non-quantitative treatment limitations (NQTLs—such as prior authorization [PA] and provider network admission requirements).

  • Non-quantitative treatment limitations (NQTLs) are also regulated under the MHPAEA, and must be offered at parity with medical and surgical services.

  • Non-quantitative treatment limitations on mental health and substance use disorder benefits in processes, strategies, evidentiary standards, or other factors must be comparable to, and are applied no more stringently than, limitations applied to medical/surgical, in the same classification.

  • Non-quantitative treatment limitations (NQTLs) are also regulated under the MHPAEA and must be offered at parity with medical and surgical services.

  • Nonquantitative treatment limitations include but are not limited to medical management, step therapy and pre-authorization.

  • Specifically, the Parity Rule included the following requirements in the four benefit classifications (Inpatient, Outpatient, Prescription Drugs, and Emergency Care):  Aggregate lifetime and annual dollar limits;  Financial requirements (FR);  Quantitative treatment limitations (QTLs);  Non-quantitative treatment limitations (NQTLs); and  Information requirements.

  • Non-quantitative treatment limitations (NQTLs) are limitations that are not expressed numerically, but otherwise limit the scope or duration of benefits for treatment.

  • In this paragraph (c)(3)(iv)(G) (Example 7), the division of outpatient, in-network benefits into any sub-classifications other than office visits and all other outpatient items and services violates the requirements of paragraph (c)(3)(iii)(C) of this section.* * * * *(4) Nonquantitative treatment limitations.

  • Nonquantitative treatment limitations on benefits include “[m]edical management standards limiting or excluding benefits based on medical necessity or medical appropriateness” and “[r]efusal to pay for higher-cost therapies until it can be shown that a lower- cost therapy is not effective (also known as fail-first policies or step therapy protocols).” 29 C.F.R.§ 2590.712(c)(4)(ii).


More Definitions of Nonquantitative treatment limitations

Nonquantitative treatment limitations or "NQTL" means
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Related to Nonquantitative treatment limitations

  • Elective Treatment and Procedures means any medical treatment or surgical procedure that is not medically necessary, including any service, treatment, or supplies that are deemed by the federal, or a state or local government authority, or by Us to be research or experimental or that is not recognized as a generally accepted medical practice.

  • Active treatment means the implementation of an individualized care plan developed under and supervised by a physician and other qualified mental health professionals that prescribes specific therapies and activities.

  • Non-Administrator Substance Use Disorder Treatment Facility means a Substance Use Disorder Treatment Facility that does not meet the definition of an Administrator Substance Use Disorder Treatment Facility.

  • Treatment zone means a soil area of the unsaturated zone of a land treatment unit within which hazardous constituents are degraded, transformed, or immobilized.

  • Less restrictive alternative treatment means a program of

  • Predictive emissions monitoring system or "PEMS" means all of the equipment necessary to monitor process and control device operational parameters (for example, control device secondary voltages and electric currents) and other information (for example, gas flow rate, O2 or CO2 concentrations), and calculate and record the mass emissions rate (for example, pounds per hour) on a continuous basis.

  • Substance abuse treatment means outpatient or inpatient services or participation in Alcoholics Anonymous or a similar program.

  • COVID-19 Measures means any quarantine, “shelter in place,” “stay at home,” workforce reduction, social distancing, shut down, closure, sequester or any other Law, directive, guidelines or recommendations by any Governmental Authority (including the Centers for Disease Control and the World Health Organization) in each case in connection with, related to or in response to COVID-19, including the Coronavirus Aid, Relief, and Economic Security Act (CARES) or any changes thereto.

  • Treatment plan means a written agreement between the department and the parent or

  • Treatment site means the anatomical description of the tissue intended to receive a radiation dose, as described in a written directive.

  • Applicable effluent standards and limitations means all State and Federal effluent standards and limitations to which a discharge is subject under the Act, including, but not limited to, effluent limitations, standards of performance, toxic effluent standards and prohibitions, and pretreatment standards.

  • Allowable emissions means the emission rate of a stationary source calculated using both the maximum rated capacity of the source, unless the source is subject to federally enforceable limits which restrict the operating rate or hours of operation, and the most stringent of the following:

  • Baseline actual emissions means the rate of emissions, in tons per year, of a regulated NSR pollutant, as determined in accordance with paragraphs (i) through (iv) of this definition.

  • Emergency Treatment means Medical Service required in an Emergency. The Emergency event or situation, and the required Medical Service cannot be and are not separated by an unreasonable period of time.

  • Opioid treatment program means a detoxification or maintenance treatment program which is required to report patient identifying information to the central registry and which is located in the state.

  • Individualized treatment plan means a written and/or electronically recorded statement of care planned for a patient based upon assessment of the patient's developmental, biological, psychological, and social strengths and problems, and including:

  • Effluent limitation guideline means a regulation published by the Administration under Section 304(b) of the CWA to adopt or revise effluent limitations.

  • Sewage treatment plant means any arrangement of devices and structures used for treating sewage.

  • Medication-assisted treatment or "MAT" means the use of pharmacologic therapy, often in combination with counseling and behav- ioral therapies, for the treatment of substance use disorders.

  • System for Award Management (SAM) database means the primary Government repository for contractor information required for the conduct of business with the Government.

  • Day Care Treatment means medical treatment, and/or surgical procedure which is:

  • COVID-19 symptoms means fever of 100.4 degrees Fahrenheit or higher, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea, unless a licensed health care professional determines the person’s symptoms were caused by a known condition other than COVID-19.

  • Treatment works means any devices and systems used in storage, treatment, recycling, and reclamation of municipal sewage and industrial wastes, of a liquid nature to implement section 201 of the Act, or necessary to recycle reuse water at the most economic cost over the estimated life of the works, including intercepting sewers, sewage collection systems, pumping, power and other equipment, and alterations thereof; elements essential to provide a reliable recycled supply such as standby treatment units and clear well facilities, and any works, including site acquisition of the land that will be an integral part of the treatment process or is used for ultimate disposal of residues resulting from such treatment.

  • Pretreatment standards means all applicable Federal rules and regulations implementing Section 307 of the Act, as well as any nonconflicting State or local standards. In cases of conflicting standards or regulations, the more stringent thereof shall be applied.

  • Categorical pretreatment standard or "categorical standard" means any regulation containing pollutant discharge limits promulgated by the environmental protection agency in accordance with sections 307(b) and (c) of the Act (33 U.S.C. section 1317) that apply to a specific category of users and that appear in 40 CFR chapter I, subchapter N, parts 405 through 471.

  • Treatment program means an abstinence based program or facility that is accredited by any of the following: