Tobacco Cessation Program Clause Samples

Tobacco Cessation Program. The CONTRACTOR shall operate a tobacco cessation program to assist Members with tobacco cessation. The tobacco cessation program shall include, at a minimum, the following: Cessation Quitline; Group counseling; Individual counseling; and U.S. Food and Drug Administration (FDA) approved pharmacotherapies and/or nicotine replacement therapies such as Bupropion, Varenicline, nicotine patch, chewing gum, nasal spray, inhaler, and lozenges. The CONTRACTOR shall not require prior authorization for tobacco cessation services, including counseling, or nicotine replacement products or therapies. The CONTRACTOR shall have no limits on length of treatment or quit attempts per year and no step therapy requirements, and shall encourage but not require enrollment in counseling as part of the tobacco cessation program. The CONTRACTOR shall establish and implement a UM program that follows NCQA UM standards and promotes quality of care, adherence to standards of care, the efficient use of resources, Member choice, and the identification of service gaps within the service system. The CONTRACTOR’s UM program shall: Ensure that Members receive services based on their current condition and effectiveness of previous treatment; Ensure that services are based on the history of the problem/illness, its context, and desired outcomes; Assist Members and/or their Representatives in choosing among Providers and available treatments and services; Ensure the use of the least restrictive setting for crisis response and stabilization, emphasizing relapse and crisis prevention, not just crisis intervention; Detect over- and under-utilization of services to assess the quality and appropriateness of services furnished to Members with special health care needs, and to identify health care disparities for remediation; Inform Population Health Management strategies and activities; Accept the New Mexico Uniform Prior Authorization Form for non-emergency medical and pharmaceutical benefits, as required per the 2019 New Mexico Health Insurance Prior Authorization Act; Respond to prescription drug prior authorization requests in accordance with NMAC 8.308.9.26.E(7)(a)(b); Ensure that prior authorization requirements comply with the requirements for parity in mental health and SUD benefits as specified in 42 C.F.R. § 438.910(d); and Ensure that prior authorization is not required for service codes specified by HCA. The CONTRACTOR shall comply with State and federal requirements for Utilization Mana...
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Tobacco Cessation Program. Covered employees can also meet this requirement if they participate in, and complete, a County-approved tobacco cessation program between January 1st and November 30th in the calendar year preceding the health insurance renewal.
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Tobacco Cessation Program. 4.8.7.1. Data collected about tobacco dependence and cessation will inform program design efforts, monitoring, and evaluation of cessation programming to ensure program- and cost- effectiveness. 4.8.7.1.1. HCPF will provide quarterly reports to DPHE, by the 15th Business Day of the following month, of claims data concerning the utilization of tobacco cessation procedures and pharmacotherapy. 4.8.7.1.1.1. HCPF will provide de-identified summary data covering utilization rates and units of service of tobacco cessation counseling provided to Medicaid Members. Data will include provider/facility name and location and de-identified client-level information, aggregated as necessary to comply with patient privacy regulations, including Member county, age group, gender, and race/ethnicity. 4.8.7.1.1.2. HCPF will provide de-identified summary data covering utilization rates and units of service of tobacco cessation counseling provided to pregnant Medicaid Members. Data will include provider/facility name and location and de-identified client-level information, aggregated as necessary to comply with patient privacy regulations, including Member county, age group, gender, and race/ethnicity. 4.8.7.1.1.3. HCPF will provide de-identified summary data covering rates of tobacco cessation pharmacotherapy and nicotine replacement therapy prescriptions filled by Medicaid Members. Data will include provider/facility name and location and de-identified client-level information, aggregated as necessary to comply with patient privacy regulations, including Member county, age group, gender, and race/ethnicity. 4.8.7.1.2. HCPF will provide annual reports to DPHE, by the 15th Business Day of the following month, of claims data concerning the prevalence of tobacco dependence. 4.8.7.1.2.1. HCPF will provide de-identified summary data covering prevalence of tobacco dependence. Data will include diagnosing provider/facility name and location and de-identified client-level information, aggregated as necessary to comply with patient privacy regulations, including Member county, age group, gender, and race/ethnicity. 4.8.7.2. Cancer Program 4.8.7.3. Data collected about cancer in Colorado will inform the development and evaluation of public health programs that will improve access to disease prevention and management. Measures will include those endorsed by the National Quality Forum (NQF) and United States Preventive Services Task Force (USPSTF) related to screening recommendations. 4.8...
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Related to Tobacco Cessation Program

  • Leave Donation Program Employees may donate paid leave to a fellow employee who is otherwise eligible to accrue and use sick leave and is employed by the same Agency. The intent of the leave donation program is to allow employees to voluntarily provide assistance to their co-workers who are in critical need of leave due to the serious illness or injury of the employee or a member of the employee's immediate family. The definition of immediate family as provided in rule 123:1-47-01 of the Administrative Code shall apply for the leave donation program. A. An employee may receive donated leave, up to the number of hours the employee is scheduled to work each pay period, if the employee who is to receive donated leave: 1. Or a member of the employee's immediate family has a serious illness or injury; 2. Has no accrued leave or has not been approved to receive other state-paid benefits; and 3. Has applied for any paid leave, workers' compensation, or benefits program for which the employee is eligible. Employees who have applied for these programs may use donated leave to satisfy the waiting period for such benefits where applicable, and donated leave may be used following a waiting period, if one exists, in an amount equal to the benefit provided by the program, i.e. fifty six hours (56) pay period may be utilized by an employee who has satisfied the disability waiting period and is pending approval, this is equal to the seventy percent (70%) benefit provided by disability. B. Employees may donate leave if the donating employee: 1. Voluntarily elects to donate leave and does so with the understanding that donated leave will not be returned; 2. Donates a minimum of eight hours; and 3. Retains a combined leave balance of at least eighty hours. Leave shall be donated in the same manner in which it would otherwise be used except that compensatory time is not eligible for donation. C. The leave donation program shall be administered on a pay period by pay period basis. Employees using donated leave shall be considered in active pay status and shall accrue leave and be entitled to any benefits to which they would otherwise be entitled. Leave accrued by an employee while using donated leave shall be used, if necessary, in the following pay period before additional donated leave may be received. Donated leave shall not count toward the probationary period of an employee who receives donated leave during his or her probationary period. Donated leave shall be considered sick leave, but shall never be converted into a cash benefit. D. Employees who wish to donate leave shall certify: 1. The name of the employee for whom the donated leave is intended; 2. The type of leave and number of hours to be donated; 3. That the employee will have a minimum combined leave balance of at least eighty hours; and 4. That the leave is donated voluntarily and the employee understands that the donated leave will not be returned. E. Appointing authorities shall ensure that no employees are forced to donate leave. Appointing authorities shall respect an employee's right to privacy, however appointing authorities may, with the permission of the employee who is in need of leave or a member of the employee's immediate family, inform employees of their co-worker's critical need for leave. Appointing authorities shall not directly solicit leave donations from employees. The donation of leave shall occur on a strictly voluntary basis.

  • Orientation Program The Company will allow a designated representative of the Local or Bargaining Unit up to one (1) hour per calendar month for the purpose of conducting the Communications, Energy and Paperworkers Union New Members’ Orientation Program. Such meetings will be conducted during the probationary period of employees, and will be held on Company premises. Employees participating in Orientation Program meetings during their normally scheduled working hours will not suffer loss of pay at their regular rate. Orientation Program meetings will be scheduled by Management and a Management representative may attend as an observer.

  • Dependent Care Assistance Program The County offers the option of enrolling in a Dependent Care Assistance Program (DCAP) designed to qualify for tax savings under Section 129 of the Internal Revenue Code, but such savings are not guaranteed. The program allows employees to set aside up to five thousand dollars ($5,000) of annual salary (before taxes) per calendar year to pay for eligible dependent care (child and elder care) expenses. Any unused balance is forfeited and cannot be recovered by the employee.

  • Health Care Savings Plan As provided in this Agreement, eligible ASF Members will participate in the health care savings plan (HCSP) established under Minnesota Statute 352.98, and as administered by the Plan Administrator. The Employer is responsible only for transferring funds, as specified in this agreement, to the Plan Administrator. Subd. 1. All ASF Members who receive severance pay as defined in Section A of this article must participate in the health care savings plan. Subd. 2. All severance pay as defined in Section B of this article shall be transferred to the severed employee's health care savings plan account. At the time of separation, if an ASF Member has an approved exception to participation in the health care savings plan account from the plan administrator, then the ASF Member shall receive this payment in one lump sum payment of cash.

  • Dental Care Plan The Welfare Plan will include a Dental Care Plan which will reimburse members for expenses incurred in respect of the coverages summarized in Appendix "1". The Plan will not duplicate benefits provided now or which may be provided in the future by any government program.