133 • if the state has an All-Payer Model Agreement, the amount that the state approves under that system. Nurse means only a person who is a registered Nurse (R.N.), a licensed vocational Nurse (L.V.N.), or a licensed practical Nurse (L.P.N.). Partial Hospitalization Care means only continuous treatment of substance use disorder or of a mental, nervous or emotional disorder or condition for at least 4 hours, but not more than 12 hours, in any 24-hour period. Participant means a person who is eligible for benefits under the Plan. Participation Agreement means the agreement providing for coverage under the Plan. Payment Percentage the percentage the Plan pays of a covered medical charge after any applicable deductible is satisfied. Physician means a doctor of medicine or a doctor of osteopathy who is licensed by his jurisdiction and acting within the scope of his license to practice medicine or to perform surgery. Plan means the National IAM Benefit Trust Fund. Preferred Provider Organization means an organization that negotiates discounted rates with medical providers in an effort to provide benefits to participants. Preferred Provider means a provider that enters into an agreement with the Preferred Provider Organization to provide services at negotiated discount rates. Pregnancy means any Pregnancy, a complication thereof, or the termination of a Pregnancy. Pregnancy benefits are payable on the same basis as benefits for treatment of an illness. Professionally Recognized Standards means professionally recognized standards of quality, as determined by the Trustees, or their delegates. To determine such standards, the Fund Office may use such groups as: The American Medical Association; The American Dental Association; their affiliates and successors; peer review groups; professional review groups; and similar groups. Qualifying Payment Amount means the amount calculated using the methodology described in 29 CFR 716-6(c). Recognized Amount means (in order of priority) one of the following: 1. An amount determined by an applicable All-Payer Model Agreement under section 1115A of the Social Security Act; 2. An amount determined by a specified state law; or 3. The lesser of the amount billed by the provider or facility or the Qualifying Payment Amount. 4. For air ambulance services furnished by Non-PPO Providers, the Recognized Amount is the lesser of the amount billed by the provider or facility or the Qualifying Payment Amount.