Emergency services

Emergency services means covered inpatient or outpatient services that are furnished by an appropriate source other than the HMO or CMP and that meet the following conditions:
(1) Are needed immediately because of an injury or sudden illness.
(2) Are such that the time required to reach the HMO's or CMP's providers or suppliers (or alternatives authorized by the HMO or CMP) would mean risk of permanent damage to the enrollee's health.

Source

42 CFR § 417.401

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Scoping language

As used in this subpart and subparts K through R of this part, unless the context indicates otherwise

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