Title 33, Chapter 18, Section 2
( 33-18-2)
As used in this chapter, the term: (1) "Additional services and supplies" means private duty nursing
care and licensed practical nursing care; physiotherapy; local
ambulance service; drugs and medications outside of the hospital;
therapeutic services and equipment, including oxygen, the rental
of oxygen equipment, hospital beds, and iron lungs; orthopedic
services and appliances, including wheelchairs, trusses, braces,
and crutches; and prosthetic devices, including artificial limbs
and eyes. Nonprofit medical service corporations are authorized to
purchase, rent, contract for, or otherwise compensate for such
additional services and supplies; and reimbursement may be made
either directly to those furnishing such additional services and
supplies or to the subscriber or member. Such additional services
and supplies shall not include hospital services. (2) "Beneficiary" or "covered dependent" means a person designated
in the subscription contract or application therefor as entitled
to the medical services referred to in paragraph (5) of this Code
section, with respect to whom appropriate dues are specified in
writing between the medical service corporation and the member
holding such certificate. (3) "Medical service corporation" means a corporation organized without capital stock and not for profit and incorporated in accordance with Code Section 33-18-4 specifically for the purpose of establishing, maintaining, and operating a nonprofit medical service plan. (4) "Medical service plan" means a plan or arrangement under which
medical services are or may be rendered to a subscriber, a covered
dependent, or other beneficiary by a licensed physician and
surgeon, dentist, or podiatrist and under which additional
services and supplies are or may be rendered to a subscriber, a
covered dependent, or other beneficiary by another person or
persons at the expense of a medical service corporation, as
defined in paragraph (3) of this Code section, in consideration of
periodical payments made by the subscriber or another in his
behalf prior to the occurrence of the condition calling for the
rendition of medical or surgical, dental, or podiatric services or
additional services and supplies. (5) "Medical services" means the general and usual services and
care rendered and administered by doctors of medicine, dental
surgery, and podiatry. It shall not include hospital service. (6) "Participating physician" means a doctor of medicine licensed
to practice medicine and surgery in this state under Chapter 34 of
Title 43 or a dental surgeon licensed to practice dental surgery
in this state under Chapter 11 of Title 43, or a podiatrist
licensed to practice podiatry in this state under Chapter 35 of
Title 43, who agrees in writing with a medical service corporation
to perform the medical services specified in the subscription
certificates issued by the medical service corporation and at such
rates of compensation as shall be determined by the board of
directors of the medical service corporation and who agrees to
abide by the bylaws, rules, and regulations of the medical service
corporation applicable to participating physicians.
(7) "Person" means a natural person, a copartnership, an
association, a common-law trust, or a corporation. (8) "Subscriber" or "member" means a person to whom a subscription
certificate is issued by a medical service corporation, which
certificate sets forth the kinds and extent of the medical
services for which the medical service corporation is liable to
make payment. |