Prioritized List of Health Services definition

Prioritized List of Health Services means the listing of conditions and treatment pairs developed by the Health Evidence Review Commission for the purpose of administering OHP.
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Prioritized List of Health Services means the Oregon Health Evidence Review Commission’s (HERC) prioritized list of health services with “expanded definitions’ of ancillary services and preventative services and the HERC practice guidelines, as presented to the Oregon Legislative Assembly for the purpose of administering the Oregon Health Plan (OHP).
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Prioritized List of Health Services. (The List) means the comprehensive list of health services, ranked by priority, from the most important to the least important. The Oregon Health Plan benefits are made from The List and determined by the Oregon Legislature.¶
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Examples of Prioritized List of Health Services in a sentence

  • Service limitations are subject to the Health Evidenced Review Commission (HERC) Prioritized List of Health Services as referenced in 410-141-0520 and the individual program chapter 410 OARs. If the client accepts financial responsibility for a non-covered service, payment is a matter between the provider and the client subject to the requirements of OAR 410-120-1280.

  • If a condition/treatment pair is not on the HERC Prioritized List of Health Services and the Division determines the condition/treatment pair has not been identified by the HERC for inclusion on the list, the Division shall make a coverage decision in consultation with the HERC.

  • Oregon sought to expand eligibility and manage costs by using managed care and a Prioritized List of Health Services.

  • These services include, but are not limited to, periodic medical and dental exams based on age, sex, and other risk factors; screening tests; immunizations; and counseling regarding behavioral risk factors (See OAR 410-141- 0520 Prioritized List of Health Services).

  • Each drug shall be prescribed for conditions funded by the Oregon Health Plan (OHP) in a manner consistent with the Health Evidence Review Commission (HERC) Prioritized List of Health Services (OAR 410-141-0480 through 410-141- 0520).

  • Diagnostic services that are necessary and reasonable to diagnose the member’s presenting condition are covered services regardless of the placement of the condition on the Prioritized List of Health Services.

  • Intensive tobacco cessation treatment is on the Health Services Commission's Prioritized List of Health Services and is covered if a documented quit date has been established.

  • The ICD-10-CM diagnosis code(s) and CPT transplant procedure code(s) are paired on the same currently funded line on the Prioritized List of Health Services adopted under OAR 410-141-0520.

  • For all other purposes, the services authorized to be provided within the medical assistance program as defined in ORS 414.025 for the physical medical, behavioral health, and dental services funded by the Legislative Assembly based upon the Prioritized List of Health Services.

  • Reference to HERC PL and/or guidelines includes the Prioritized List of Health Services, guideline notes, and the body of literature behind the guideline notes.


More Definitions of Prioritized List of Health Services

Prioritized List of Health Services means the listing of Condition/Treatment Pairs developed by the HSC for the purpose of implementing the OHP. See OAR 410-141-0520, Prioritized List of Health Services, for the listing of Condition/Treatment Pairs.
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Prioritized List of Health Services has the meaning provided for in OAR 410-120-0000. “Prioritized Populations” has the meaning provided for in OAR 410-141-3870.
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Prioritized List of Health Services means the listing of Condition/Treatment Pairs developed by the HSC for the purpose of implementing the OHP. See OAR 410-141-0520, for the listing of Condition/Treatment Pairs.
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Related to Prioritized List of Health Services

  • Health service area or “HSA” refers to the distinct geographic regions described in Section 4.1.4 or the Vermont Blueprint for Health Manual.

  • Analytical x-ray system means a group of components utilizing x-rays to determine the elemental composition or to examine the microstructure of materials.

  • Provider of health care means a physician or physician assistant licensed pursuant to chapter 630, 630A or 633 of NRS, perfusionist, dentist, licensed nurse, dispensing optician, optometrist, practitioner of respiratory care, registered physical therapist, podiatric physician, licensed psychologist, licensed audiologist, licensed speech-language pathologist, licensed hearing aid specialist, licensed marriage and family therapist, licensed clinical professional counselor, chiropractor, licensed dietitian or doctor of Oriental medicine in any form.

  • 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.

  • Behavioral health services means mental health services as

  • Behavioral health treatment means counseling and treatment programs, including applied behavior analysis, that are:

  • Basic health plan means the plan described under chapter

  • 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.

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

  • 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:

  • Health services means, but shall not be limited to, examination, diagnosis, evaluation, treatment, pharmaceuticals, aftercare, habilitation or rehabilitation and mental health therapy of any kind, as well as payment or reimbursement for any such services.

  • Department of Health means the Washington state department of

  • Critical access hospital or “CAH” means a hospital licensed as a critical access hospital by the department of inspections and appeals pursuant to rule 481—51.52(135B).

  • Database Management System (“DBMS”) is a computer process used to store, sort, manipulate and update the data required to provide Selective Routing and ALI.

  • In Patient Care means treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered event.

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).

  • Basic health care services means in and out-of-area emergency services, inpatient hospital and

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • Critical Path means those Trade Contractor Work activities identified on the Construction Schedule which, if delayed, will cause a corresponding Delay in the Substantial Completion Date.

  • 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.