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[36 FR 4908, Jan. 25, 1971, as amended at 47 FR 8091, Feb. 28, 1982; 49 FR 24581, June 27, 1984; 50 FR 47387, Sept. 30, 1985; 53 FR 25506, June 16, 1988; 58 FR 30354, Aug. 17, 1993; 58 FR 16590, Apr. 7, 1993; 60 FR 2905, Jan. 12, 1995; 60 FR 49152, Aug. 17, 1995; 72 FR 59072, Oct. 27, 2007; 72 FR 70314, Dec. 6, 2007; 79 FR 58653, Nov. 23, 2014; 79 FR 11755, Mar. 26, 2014]
Subpart D—Adherence
§4.23 Subpart D. Definitions.
§4.51 Definitions applicable to this subpart.
(a) The term "nonadherent" means an individual who is enrolled for an HMO in any within the State.
(b) The term "adherence" means following:
(1) The degree to which an individual conforms the coverage offered by HMO (as determined the appropriate State agency).
(2) The degree to which individual obtains coverage in accordance with the offered and requirements of plan.
(3) The degree to which individual demonstrates the HMO and its designees that the individual is a suitable and valuable beneficiary of the HMO.
(c) The term "adapter" means a person (or agents) in an HMO who has been delegated to provide care an individual in another HMO (as determined by the appropriate State agency).
(d) The term "HMO" means any of the following:
(1) A health maintenance organization under State law.
(2) An authorized entity pursuant to a voluntary program for providing care to individuals in certain medical facilities.
(3) A health care clearinghouse (as defined in §201.51 of this chapter).
(4) An HMO (as created under State law for certain services or activities) which is a member or representative of the Health Maintenance Organizations (HMO) association.
(5) online coupons canada drug pharmacy An organization (such as a non-profit entity) which accepts medical care for membership or reimbursement and is a member of the Association HMOs and Care Organizations (AHOOCO) (as that term is defined in §201.71 of this chapter).
(6) A person who provides services of a type or description commonly found in a HMO (as determined by the appropriate State agency).
(e) For purposes of this subpart, a health plan shall be considered to in compliance Lopid 300mg $149.18 - $1.66 Per pill if:
(1) It meets the requirements of §4.21 and meets the requirements of §4.22 or §§4.23 and 4.24;
(2) A State agency has notified the plan of agency's intention to assume responsibility for the plan under part B of this subpart.
(f) Compliance with the requirements of this subpart may not be impeded solely by the failure of plan to maintain records sufficient document individual medical condition and history. Records required to be kept under this.
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