HomeMy WebLinkAboutMINUTES - 07251989 - 1.34 To: BOARD OF SUPERVISORS 1- 034
FROM: Victor J. Westman, County Couns �ttff ;A ,-,(,� , ,s �t�,,�;...,, Cc tra
By: Andrea W. Cassidy, Deputy ri ounty,, Counsel -1 1<
DATE: July 7, 1989 $9 JUL -3 P11 3: C�
SUBJECT: 1St Choice Health Plan Amendment lJ
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDATIONS:
Amend the 1st Choice Health Plan exclusions from coverage
[provision (HH) ] to define in plain language, temporomandibular
joint syndrome for which treatment is not a covered benefit.
This redefinition will assist in enforcing the exclusion.
This amendment does not change the covered benefits it only
clarifies the plan document language to be consistent with the
case law.
BACKGROUND:
The current language states:
"Any service or supply relative to
treatment of conditions caused by or
attributed to the temporomandibular joint
except for medically necessary treatment
arising from acute dislocations, fractures,
neoplasms, rheumatoid arthritis, ankylosing
spondylitis or dissgminated lupus
erythematosus . "
The language of the amendment is:
"Any service or supply relative to
treatment of temporomandibular joint syndrome
which is a disfunction of the
temporomandibular joint (where the moveable
jaw attaches to the skull in front of the
ears ) marked by a clicking or grinding
sensation and pain in or about the ears . "
AWC:da
dal:lat.amd
10/
CONTINUED ON ATTACHMENT: _ YES SIGNATURE.:
_ RECOMMENDATION OF COUNTY ADMINISTRATOR. RECOMMEND 6N OF BOARD COMM.I:TTEE.
APPROVE OTHER
SIGNATURE I S :
ACTION OF BOARD ON _ July 25 , 1989 APPROVED AS RECOMMENDED, X OTHER.
VOTE OF SUPERVISORS
t HEREBY CERTIFY THAT THiIIS IIS A. TRUE
X UNANIMOUS (ABSENT AND CORRECT' COPY OF AN; ACTION, TAKEN!
AYES: NOES:. AND� ENTERED On THE: MfNUTES OF THE BOARD,
_ ABSENT: ABSTAIN* OF SUPERVIiSORS� ONi THE: DATE: SHOWNi..
Originating Department - Personnel-Benefits Division
cc: County Administrator ATTESTED _ July 25 , 1989 _
County Counsel PHIL. BATCHELOR', CLERK. OF THE: BOARD OF
Auditor-Controller SUPERVISORS; AND COUNTY ADMINISTRATOR:
BY
M -83 _ ,DEPUTY'
382/7