471 Neb. Admin. Code, ch. 11, § 001

Current through September 17, 2024
Section 471-11-001 - Definitions

Encounter: A face-to-face visit, including telehealth services provided in accordance with 471 NAC 1-006, between a health care professional and an individual eligible for the provision of medically necessary Medicaid-defined services in an IHS or Tribal (638) facility within a 24-hour period ending at midnight, as documented in the client's medical record.

Indian or Indians: An individual who meets any of the definitions in 25 U.S.C. §§ 1603(3), 1603(13), and 1679, or who has been determined eligible, as an Indian, pursuant to 42 C.F.R. §§ 136.1 and 136.12 or Title V of the Indian Health Care Improvement Act, to receive health care services from Indian health care providers (IHS, an Indian Tribe, Tribal Organization, or Urban Indian Organization - I/T/U) or through referral under Contract Health Services ( 25 U.S.C § 1603(5) ).

Indian Health Service (IHS): An agency within the United State Department of Health and Human Services, which is responsible for providing federal health services to American Indians and Alaska Natives.

IHS Provider: A health care program, including contract health services (25 U.S.C § 1603(5)) , operated by the Indian Health Service or by an Indian Tribe, Tribal Organization, or Urban Indian Organization as those terms are defined 25 U.S.C. § 1603. This includes Hospitals, Hospital Based Facilities, Pharmacies and outpatient clinics.

IHS Supplier: A freestanding (non-hospital based) entity that furnishes durable medical equipment, prosthetics, orthotics, supplies, and parenteral or enteral nutrition.

IHS Physician or Practitioner: Physician and non-physician practitioners billing for services under Medicaid.

471 Neb. Admin. Code, ch. 11, § 001

Adopted effective 6/5/2018