Retrospective review means a review of medical necessity conducted after services have been provided to a patient, but does not include the review of a claim that is limited to an evaluation of reimbursement levels, veracity of documentation, accuracy of coding, or adjudication for payment.
Prospective review means utilization review conducted prior to an admission or a course of treatment.
Adaptive Reuse means a proposed development that will be repurposed from what it was originally built and designed for. Except where stated otherwise, rehabilitation requirements in Threshold apply to Adaptive Reuse projects.
Lapsed Policy means a Policy which has not acquired the Surrender Value and where the due Premium has not been received till the expiry of the Grace Period.
Administrative Review means any decision making process of the director requested by a party aggrieved with an action taken under these rules except the hearing process described in OAR 436-001.
R&W Policy means those certain buyer-side representations and warranties insurance policies purchased by Buyer in connection with this Agreement.
Workers’ Compensation As required by any applicable law or regulation. Employer's Liability Insurance: must be provided in amounts not less than listed below: Minimum limits: $500,000 each accident for bodily injury by accident $500,000 policy limit for bodily injury by disease $500,000 each employee for bodily injury by disease
Appeal means a request for a review of the Floodplain Administrator's interpretation of any provision of this ordinance.
CSR Policy means the present Corporate Social Responsibility Policy of the Company, which covers the activities to be undertaken by the Company as specified in Schedule VII to the Act and the CSR Expenditure thereon.
Civil Relief Act The Soldiers' and Sailors' Civil Relief Act of 1940, as amended.
Rebates means rebates, price reductions and administrative fees and related adjustments charged by or payments to state Medicaid and other federal, state and local governmental programs and their participants, and by health plans, insurance companies, Medicare Part D prescription drug plans, pharmacy benefits managers, mail service pharmacies, long term care providers, specialty pharmacies and other health care providers based upon the utilization and sales of the Product, and service, administrative and inventory management fees due to wholesalers, distributors and group purchasing organizations based on sales of the Product (in each case, other than chargeback claims).
Medicare means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.
Medicare cost report means CMS-2552-10, the cost report for electronic filing of
Parent of a covered servicemember means a covered servicemember’s biological, adoptive, step or foster father or mother, or any other individual who stood in loco parentis to the covered servicemember. This term does not include parents “in law.”
Policy Grievance shall be signed by a xxxxxxx or a Union representative or, in the case of an Employer's policy grievance, by the Employer or its representative.
Claims-made coverage means an insurance contract or provision limiting
Civil penalty means the payment Licensee has agreed to pay to the United States Treasury;
Harassment means a pattern of unwelcome verbal or physical conduct relating to another person's constitutionally or statutorily protected status that causes, or reasonably should be expected to cause, substantial interference with the other's performance in the school environment; and
Paid sick leave – means paid leave under the Emergency Paid Sick Leave Act.
Medicaid means that government-sponsored entitlement program under Title XIX, P.L. 89-97 of the Social Security Act, which provides federal grants to states for medical assistance based on specific eligibility criteria, as set forth on Section 1396, et seq. of Title 42 of the United States Code.
the Commissioners means the Commissioners for Her Majesty’s Revenue and Customs;
Unemployment Insurance means the contribution required of Vendor, as an employer, in respect of, and measured by, the wages of its employees (or subcontractors) as required by any applicable federal, state or local unemployment insurance law or regulation.
General relief means money payments and other forms of relief made to those persons mentioned
MERS Procedure Manual The MERS Procedures Manual, as it may be amended, supplemented or otherwise modified from time to time.
Next of kin of a covered servicemember means the nearest blood relative other than the covered servicemember’s spouse, parent, son, or daughter, in the following order of priority: blood relatives who have been granted legal custody of the covered servicemember by court decree or statutory provisions, brothers and sisters, grandparents, aunts and uncles, and first cousins, unless the covered servicemember has specifically designated in writing another blood relative as his or her nearest blood relative for purposes of military caregiver leave under the FMLA. When no such designation is made and there are multiple family members with the same level of relationship to the covered servicemember, all such family members shall be considered the covered servicemember’s next of kin, and the employee may take FMLA leave to provide care to the covered servicemember, either consecutively or simultaneously. When such designation has been made, the designated individual shall be deemed to be the covered servicemember’s only next of kin.
Administrative Requirement means any required notice, filing or other similar administrative requirements (other than any requirement for Consent or any Eligibility Requirements) for the Transfer of any Appointment to the applicable Purchaser as set forth in the related Corporate Trust Contract.