Title 49, Chapter 4, Section 141
( 49-4-141)
As used in this article, the term: (1) "Applicant for medical assistance" means a person who has made
application for certification as being eligible, generally, to
have medical assistance paid in his or her behalf pursuant to the
state plan and whose application has not been acted upon
favorably. (2) "Board" means the Board of Community Health established under
Chapter 5A of Title 31. (3) "Commissioner" means the commissioner of the department. (4) "Department" means the Department of Community Health
established under Chapter 5A of Title 31. (5) "Medical assistance" means payment to a provider of a part or
all of the cost of certain items of medical or remedial care or
service rendered by the provider to a recipient of medical
assistance, provided such items are rendered and received in
accordance with such provisions of Title XIX of the federal Social
Security Act of 1935, as amended, regulations promulgated pursuant
thereto by the secretary of health and human services, all
applicable laws of this state, the state plan, and regulations of
the department which are in effect on the date on which the items
are rendered. (6) "Provider of medical assistance" means a person or
institution, public or private, which possesses all licenses,
permits, certificates, approvals, registrations, charters, and
other forms of permission issued by entities other than the
department, which forms of permission are required by law either
to render care or to receive medical assistance in which federal
financial participation is available and which meets the further
requirements for participation prescribed by the department and
which is enrolled, in the manner and according to the terms
prescribed by the department, to participate in the state plan. (7) "Recipient of medical assistance" means a person who has been
certified eligible, pursuant to the state plan, to have medical
assistance paid in his or her behalf. (8) "State plan" means all documentation submitted by the
commissioner in behalf of the department to and for approval by
the secretary of health and human services, pursuant to Title XIX
of the federal Social Security Act, as amended (Act of July 30,
1965, P.L. 89-97, Stat. 343, as amended). (9) "Third party" means an individual, institution, corporation,
or public or private agency, other than the department, that is
legally liable to pay all or any part of the medical costs
incurred by a recipient of medical assistance on account of any
sickness, injury, disease, or disability to such a recipient. |