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  2. Medical necessity - Wikipedia

    en.wikipedia.org/wiki/Medical_necessity

    The use of cannabis (also known as marijuana) for medical purposes is a notable medical necessity case. Cannabis is a plant whose active ingredients are widely reported by patients to be effective in pain control for various conditions, usually neuropathic in nature, in which common painkillers have not had great benefit.

  3. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  4. Certificate of medical necessity - Wikipedia

    en.wikipedia.org/wiki/Certificate_of_medical...

    Physician's News Digest article on Certificates of Medical Necessity; Statutory definition of a CMN at the SSA website; Medicare manual that provides exhaustive information about the practical use of CMNs, particularly section 5.3. This is the official source of information for contractors administering the Medicare system about the use of CMNs.

  5. Certificate of need - Wikipedia

    en.wikipedia.org/wiki/Certificate_of_need

    [1] [2] [3] Certificates of need are necessary for the construction of medical facilities in 35 states and are issued by state health care agencies: The certificate-of-need requirement was originally based on state law. New York passed the first certificate-of-need law in 1964, the Metcalf–McCloskey Act.

  6. Emergency Medical Treatment and Active Labor Act - Wikipedia

    en.wikipedia.org/wiki/Emergency_Medical...

    An emergency medical condition (EMC) is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious ...

  7. CURB-65 - Wikipedia

    en.wikipedia.org/wiki/CURB-65

    CURB-65, also known as the CURB criteria, is a clinical prediction rule that has been validated for predicting mortality in community-acquired pneumonia [1] and infection of any site. [2] The CURB-65 is based on the earlier CURB score [3] and is recommended by the British Thoracic Society for the assessment of severity of pneumonia. [4]

  8. Medical eligibility criteria for contraceptive use - Wikipedia

    en.wikipedia.org/wiki/Medical_Eligibility...

    However, people with medical conditions may need to have contraceptive options tailored around their specific needs. [1] Resources exist for patients and providers to help tailor methods. One example of a resource is the Medical Eligibility Criteria for Contraceptive Use (MEC), [2] [3] which exists in multiple formats.

  9. Necessity and sufficiency - Wikipedia

    en.wikipedia.org/wiki/Necessity_and_sufficiency

    In logic and mathematics, necessity and sufficiency are terms used to describe a conditional or implicational relationship between two statements. For example, in the conditional statement : "If P then Q ", Q is necessary for P , because the truth of Q is guaranteed by the truth of P .