America's Affordable Health Choices Act of 2009, October 14, 2009, 111-1 House Report 111-299, Part 1, *2009 |
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Страница 11
... subparagraph ( B ) . ( B ) REFERENCE BENEFITS PACKAGE DESCRIBED . - The reference benefits package described in this subparagraph is the essential benefits package if there were no cost - sharing imposed . ( d ) ABORTION COVERAGE ...
... subparagraph ( B ) . ( B ) REFERENCE BENEFITS PACKAGE DESCRIBED . - The reference benefits package described in this subparagraph is the essential benefits package if there were no cost - sharing imposed . ( d ) ABORTION COVERAGE ...
Страница 17
... subparagraph is 14 days after the date the program receives the specified additional information , but in no case later than 28 days after the date of receipt of the request for the prior authorization . This clause shall not apply if ...
... subparagraph is 14 days after the date the program receives the specified additional information , but in no case later than 28 days after the date of receipt of the request for the prior authorization . This clause shall not apply if ...
Страница 18
... subparagraph ( B ) , shall be an appropriate specialist ; ( ii ) has been selected by the plan or entity ; and ( iii ) did not make the initial denial in the internally appealable deci- sion . ( B ) LIMITED SCOPE COVERAGE DEFINED ...
... subparagraph ( B ) , shall be an appropriate specialist ; ( ii ) has been selected by the plan or entity ; and ( iii ) did not make the initial denial in the internally appealable deci- sion . ( B ) LIMITED SCOPE COVERAGE DEFINED ...
Страница 20
... subparagraph ( B ) , a plan or entity may con- dition the use of an external appeal process upon payment to the plan ... subparagraph ( D ) , the external appeal process under this section of a plan or entity shall be conducted under a ...
... subparagraph ( B ) , a plan or entity may con- dition the use of an external appeal process upon payment to the plan ... subparagraph ( D ) , the external appeal process under this section of a plan or entity shall be conducted under a ...
Страница 22
... subparagraph ( C ) ( i ) , by a qualified private standard - setting organization ( certified under such sub- paragraph ) ; or ( ii ) a QHBP offering entity that is a health insurance issuer oper- ating in a State , the qualified ...
... subparagraph ( C ) ( i ) , by a qualified private standard - setting organization ( certified under such sub- paragraph ) ; or ( ii ) a QHBP offering entity that is a health insurance issuer oper- ating in a State , the qualified ...
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111TH CONGRESS administrative Advisory agencies amount applicable appropriate areas assistance authorized Center clause clinical Commissioner Committee Congress contract coordination cost-sharing costs coverage Current Law dual eligibles durable medical equipment employers enactment end the following enrollee enrollment ensure establish evaluation federal fiscal funds GENERAL.-Section grant Health and Human health benefits plan health care Health Insurance Exchange health plan health workforce HIPAA hospital Human Services implement improve individual inserting items and services Law This provision Medicaid medical home Medicare Part D Medicare Prescription Drug ment mental health counselor nursing facility participate patient payment period PHSA sec PHSA section PHSA title physician pilot program premium prescription drug preventive services Proposed Law qualified health benefits quality measures rebate resident respect retary Security Act 42 Social Security Act specified standards striking submit subparagraph subsection Subtitle Task Force telehealth term tion United States Code