Md. Code Regs. 10.09.58.02

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.58.02 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1)

"Advanced practice nurse" means an individual who meets the requirements in COMAR 10.09.01.

(2) "Department" means the Department of Health and Mental Hygiene as defined in COMAR 10.09.36.01B.

(3) "Early and Periodic Screening, Diagnostic and Treatment (EPSDT)" means the provision to individuals younger than 21 years old, of preventative health care under 42CFR § 441.50 et seq. as amended, and other health care services, diagnostic services, and treatment services that are necessary to correct or ameliorate defects and physical and mental illnesses and conditions discovered by EPSDT screening services.

(4) "Family planning" means providing individuals with the information and means to prevent unwanted pregnancy and maintain reproductive health.

(5) "Free-standing clinic" means a health care facility that is not licensed as a hospital, part of a hospital, or nursing home, and is not administratively part of a physician's, dentist's, or osteopath's office, but which has a separate staff functioning under the direction of a clinic administrator or health officer and is organized and operated to provide ambulatory health services.

(6) "Hospital" means an institution that is licensed pursuant to COMAR 10.07.01, or other applicable standards established by the state in which the service is provided.

(7) "Local health department (LHD)" means the Baltimore City Health Department and its subgrantees, or a county health department and its subgrantees.

(8) "Medical Assistance Program" has the meaning stated in COMAR 10.09.36.01B.

(9) "Medical laboratory" means a licensed or certified facility, place, establishment, or institution, operated for the examination of material derived from the human body, by means of one or more of the scientific disciplines, for the purpose of obtaining scientific data that may be used to determine the presence, source, progress, or identity of disease agents, and to aid in the prevention, diagnosis, treatment, and management of human disease.

(10) "Medically necessary" has the meaning stated in COMAR 10.09.36.01B.

(11) "Medicare" means the insurance program administered by the federal government under Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq.

(12) "Participant" means an individual who is certified as eligible for the Family Planning Program as described in COMAR 10.09.37.

(13) "Physician" means an individual licensed to practice medicine in the state in which the physician's practice is located.

(14) "Physician assistant" means an individual who meets the requirements in COMAR 10.09.55.

(15) "Physician office and other point-of-care laboratory" means a medical laboratory at a site or facility operated as a part of, or in association with, the medical practice of licensed medical practitioners permitted to perform clinical laboratory procedures, community health center, emergency treatment center, health maintenance organization, or county or local health department, where clinical laboratory procedures are performed for patients seen by the practitioner or a practitioner employed or otherwise engaged by one of these entities.

(16) "Program" means the Maryland Medical Assistance, Family Planning Program.

(17) "Provider" means a health care provider who:

(a) Meets the licensure requirements set forth in Regulation .03 of this chapter;

(b) Meets the conditions for participation set forth in Regulation .04 of this chapter; and

(c) Provides the services described in Regulation .05 of this chapter.

Md. Code Regs. 10.09.58.02

Regulations .02 adopted as an emergency provision effective October 19, 1994 (21:23 Md. R. 1930); adopted permanently effective April 10, 1995 (22:7 Md. R. 536)
Regulation .02B amended effective August 27, 2007 (34:17 Md. R. 1507)
Regulation .02B amended as an emergency provision effective January 1, 2012 (39:2 Md. R. 139); amended permanently effective June 11, 2012 (39:11 Md. R. 686); amended effective 45:26 Md. R. 1243, eff. 12/31/2018