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it is lnvestigatlonal . A health Intervention not meeting all of the following criteria , is, In the Company's Jud_gment, trweallgationa!: • The Sc enUfic Evidence rnust permit conclusions concerning the effect of the Health Intervention on health outcomes, which In.elude the dlaease process . Inj ury or lllnes.s , lengih of Hfe, ablllty lo funciion and quality of llro . • The health Intervention must Improve net health outcome. • The Scientific Evidence must show that the health inteiventlon Is as beneficial as any established alternatives. • The improvement must be attainable outside the laboratory or clinical research setting. For pu rposes of lhls de Rn Ilion. S<;lentlflc Evidence me.ans sci en tific: studies published n or accepted for pt.lb.If cation by med ca l Journals that meet nat onatty recognized requrrements for scientific manuscripts and thBt submil moat of their publlshereview by experts who are not part. of the ed ltorlel elaff;· or findings, studies or research conducted by or unde r the auspices of federal government agei,cles and nationally recogn ized federal research ins litutes . However, Solentlf\c Evidence shall nol li'!clude puhllshad pear--revle'Ned ll lerature sporasored to a significant extenl by a ph-armaceutlcal manufacturing company or medical device manufacturar or a single study without other suppol1able studies . II. PROVISION OF MEDICAL SERVICES 2.1 MEDICAL L 'r'. ...QsSSARV SERVICES -Medical Group will ptovlde Med ically Necessary Se rvices lo Members In ~rdance wit'1 the h1m,s of th i s Agreement Company will only be~r llnancial responsibility for Med ically Necessary , Govered Seivlces fumtshe.d to Members by Med ical Group. Company will' not make retroactille denials of Covered Services that were pre-certlffed 01 concurrenUy certifleil as medically nece:s.sary unless the certlllcatron was ~d upon a material m srepresantat on by Medical Group , 2.2 COVERED SERVICES -Company will define the Covered Servicas for the Health Plans ,for wt,fch Med ical Group has agreed to prov ide service,. 2.3 STANDARDS OF CARE -The Medlcaf Group &hell provide ·servic~ to Members In accordance with ganereJly accepted p10fes1 lonal standards or care and medical and billing praclice& In the c:ommunfly. Med ical Group agrees lo furn ish Covered Services to Members without regard to the .Member's enroflmenl in lhe Health Plan as a private purchaser or as a part ici pant in publicly funded programs . 2.4 RELATIONSHIP TH MEMBeRs -Cornpany will not be liable for nor w111 It eKercise o<>ntrol or dfrectlon over the methods or profesaional judgments relied upon by Medlcal Group and Medical Group's Pr011iden1, employees· or representatives In provid ing services putsuant to this Agreement. Med ical Gro\:lp wtll be solely responsible for supervising "nd controlling Medical Group 's employees to assure that such services are pro11lded In a manner that compnes With generally accepted slanl:lards of ca1e . Meolcal Group Provider will be responelble for cllnlcal decisions regarding the medical care and treatment of Members. Noth ing fi:, lh l a Agreement Omits Med eat Group Provider 's right lo commun icate freely with Members. fncludJng the rl_gt,I lo Inform Members that Medical Group Provider tiejleves services are appropriate Of necessary ; even if Company has determlned the services are not Covered Services. 2.5 t:I.Q.N.QISCRIMINATION • Medical Group wlll provide the Covered Services contemplated herein without rcgirrd to o,e race , age . sex·. religion , creed , color , national orfg !n er ancestry of any Member. During the term of this Agreement , Medical Group will not unlawfully dlscrtmrnate against any employee or appl icant for employment bei:ause or race , fellglor,, color , national orig in, ancestry , physical handicap, health slatus , marital Asurla MGA Agreement (Rev. 0612017) A18818854AA Page 4 al 20