Md. Code Regs. 10.09.91.02

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

Section 10.09.91.02 - Definitions

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

(1) "Applicant" means an individual who has applied for presumptive eligibility at a participating hospital.

(2) "Application" means the presumptive eligibility application.

(3) "Authorized representative" has the same meaning as set forth in COMAR 10.01.04.01.

(4) "Department" means the Department of Health and Mental Hygiene which is the single State agency designated to administer the Maryland Medical Assistance Program pursuant to Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq.

(5) "Determination" means a decision regarding an applicant's presumptive eligibility.

(6) "Federal poverty level" means the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. § 9902(2).

(7) "Former foster care" means an individual who:

(a) Is younger than 26 years old;

(b) Is not eligible and enrolled for coverage under a mandatory Medical Assistance group other than childless adult; and

(c) Was formerly in a Maryland out-of-home placement, including categorical Medical Assistance:

(i) On attaining age 18 and leaving out-of-home placement; or

(ii) On attaining age 19-21 during extended out-of-home placement under COMAR 07.02.11.04B.

(8) "Hospital" means an institution which:

(a) Falls within the jurisdiction of Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland; and

(b) Is licensed pursuant to COMAR 10.07.01 or other applicable standards established by the state in which the service is provided.

(9) "Income" means property or a service received by an individual in cash or in-kind, which can be applied directly, or by sale or conversion, to meet basic needs for food, shelter, and medical expenses.

(10) "Incarcerated inmate in a public institution" has the meaning stated in COMAR 10.09.24.05-5B.

(11) "Medical Assistance" means the program administered by the State under Title XIX of the Social Security Act, which provides comprehensive medical and other health-related care for eligible individuals.

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

(13) "Presumptive eligibility" means temporary eligibility for Medical Assistance as determined by participating hospitals in accordance with these regulations.

Md. Code Regs. 10.09.91.02

Regulations .02 adopted effective 41:25 Md. R. 1485, eff.12/22/2014