Authorization Limits Clause Samples
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Authorization Limits. The MCO may place appropriate limits on a service on the basis of criteria such as medical necessity; or for the purpose of utilization management, provided the services furnished can reasonably be expected to support the member’s long term care outcomes as defined in Article I, Definitions. After the initial MCP, when a specific service is identified as necessary to support a member’s long term care outcomes on an ongoing basis and the IDT has determined that the current provider is effective in providing the service, the service shall generally be authorized for the duration of the current MCP (i.e., until the next regularly scheduled MCP update) in an amount necessary to support the member’s outcomes. The number of units of service or duration of a service authorized may be more limited when the authorization is for: An episodic service or course of treatment intended to meet a need that is anticipated to be short term in nature, which may be authorized for a limited length of time or number of units of service that is expected to be sufficient to meet the short term need. A trial-basis service or course of treatment intended to test whether a particular service or course of treatment is an effective way to support the long term care outcome or need of the member, which may be authorized for a length of time or number of units of service that is expected to be sufficient for the IDT, including the member, to determine whether or not the services or course of treatment is in fact effective in meeting the member’s outcome or need. Services may be discontinued when a limitation in an original service authorization for an episodic service or course of treatment is reached. If the member requests additional services the IDT staff must respond in accordance with paragraph 8, Responding to Direct Requests By a Member for a Service, of this section.
Authorization Limits. The MCO may place appropriate limits on a service on the basis of criteria such as medical necessity; or for the purpose of utilization management, provided the services furnished can reasonably be expected to support the member’s long-term care outcomes as defined in Article I, Definitions. After the initial MCP, when a specific service is identified as necessary to support a member’s long-term care outcomes on an ongoing basis and the IDT has determined that the current provider is effective in providing the service, the service shall generally be authorized for the duration of the current MCP (i.e., until the next regularly scheduled MCP update) in an amount necessary to support the member’s outcomes. The number of units of service or duration of a service authorized may be more limited when the authorization is for: An episodic service or course of treatment intended to meet a need that is anticipated to be short term in nature, which may be authorized for a limited length of time or number of units of service that is expected to be sufficient to meet the short-term need. A trial-basis service or course of treatment intended to test whether a particular service or course of treatment is an effective way to support the long-term care outcome or need of the member, which may be authorized for a length of time or number of units of service that is expected to be sufficient for the IDT, including the member, to determine whether or not the services or course of treatment is in fact effective in meeting the member’s outcome or need. Services may be discontinued when a limitation in an original service authorization for an episodic service or course of treatment is reached. If the member requests additional services the IDT staff must respond in accordance with paragraph 8, Responding to Direct Requests By a Member for a Service, of this section.
Authorization Limits. 2.20.1. You may notify us of an authorization limit applicable to some or all trades either in general or for particular Authorized Users. You may withdraw any such authorization limit at any time by giving us notice in writing. We may, in our absolute discretion, impose an authorization limit on you and/ or any Authorized Users or vary any such limit at any time by giving you notice in writing in accordance with clause 2.29.
Authorization Limits. (a) The Customer may inform Custom House of an Authorization Limit applicable to some or all Orders including Forward Contracts and/or Option Contracts (either individually or in aggregate or both) either in general or for particular Authorized Users.
(b) Any Authorization Limit provided by the Customer to Custom House may be withdrawn by the Customer at any time by giving Notice to Custom House.
Authorization Limits. Reimbursable Expenses shall not, without prior written approval by District, cumulatively exceed any maximum or not-to-exceed amount(s) applicable to Reimbursable Expenses that are set forth in Supplemental Compensation Provisions - Exhibit “C” attached hereto. Reimbursable Expenses that exceed any such maximum or not-to-exceed amount without the prior written approval by the District shall be borne by Consultant at its own expense, without reimbursement or payment by District.