Common use of Class Members Clause in Contracts

Class Members. Only Class Members are entitled to Review Relief set forth above in § VI.1. Class Members must meet all of the following criteria: a. The Class Member must be a beneficiary of Medicare Part A or B, in Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island or Vermont; b. The Class Member must have received a “favorable final appellate decision” that he or she was “confined to home,” i.e., homebound, in the appeal of a home health nursing or therapy claim denial; c. The Class Member must have subsequently been denied, or will be denied, coverage for additional service on the basis of not being homebound, on or after January 1, 2010; d. The Class Member must have had a non-lapsed, viable appeal of the subsequent denial for coverage of additional home health services as of March 5, 2015; and e. The Class Member must have had a claim for Medicare home health coverage filed on his or her behalf on or before August 2, 2015.