35 Pa. Stat. § 5701.1102
The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise:
"Bad debt expense." The cost of care for which a hospital expected payment from the patient or a third-party payor, but which the hospital subsequently determines to be uncollectible.
"Charity care expense." The cost of care for which a hospital ordinarily charges a fee but which is provided free or at a reduced rate to patients who cannot afford to pay but who are not eligible for public programs and from whom the hospital did not expect payment in accordance with the hospital's charity care policy.
"Children's Health Insurance Program." The insurance program established by Article XXIII of the act of May 17, 1921 (P.L. 682, No. 284), known as The Insurance Company Law of 1921.
"Council." The Health Care Cost Containment Council established under the act of July 8, 1986 (P.L. 408, No. 89) , known as the Health Care Cost Containment Act.
"Department." The Department of Public Welfare of the Commonwealth.
"Emergent medically necessary services." Immediate medical care consistent with the definition of emergency service as set forth in section 2116 of the act of May 17, 1921 (P.L. 682, No. 284), known as The Insurance Company Law of 1921.
"Extraordinary expenses." The cost of hospital inpatient services provided to an uninsured patient which exceeds twice the hospital's average cost per stay for all patients.
"Hospital." A health care facility licensed as a hospital pursuant to the act of July 19, 1979 (P.L. 130, No. 48) , known as the Health Care Facilities Act, or pursuant to Article X of the act of June 13, 1967 (P.L. 31, No. 21), known as the Public Welfare Code.
"Inpatient day." A billing unit corresponding to each day an individual stays in a hospital as a patient.
"Insurer." Any insurance company, association, reciprocal, health maintenance organization, fraternal benefits society or a risk-bearing preferred provider organization that offers health care benefits and is subject to regulation under the act of May 17, 1921 (P.L. 682, No. 284), known as The Insurance Company Law of 1921, or the act of December 29, 1972 (P.L. 1701, No. 364), known as the Health Maintenance Organization Act. The term includes an entity and its subsidiaries that operate subject to the provisions of 40 Pa.C.S. Ch. 61 (relating to hospital plan corporations) or 63 (relating to professional health services plan corporations).
"Medical assistance." The State program of medical assistance established under Article IV(f) of the act of June 13, 1967 (P.L. 31, No. 21), known as the Public Welfare Code.
"Medical assistance day." An inpatient day provided by a hospital to a patient enrolled in the State program of medical assistance established under the act of June 13, 1967 (P.L. 31, No. 21), known as the Public Welfare Code, or for a similar program in other states.
"Medicare SSI day." An inpatient day provided by a hospital to a patient enrolled in both Medicare Part A and Supplemental Security Income (SSI) as determined by the Centers for Medicare and Medicaid Services.
"Net patient revenue." The estimated net realized amounts from patients, third-party payors and others for health care services rendered, including estimated retroactive adjustments due to future audits, reviews, settlements and investigations. Retroactive adjustments are accrued on an estimated basis in the period the relative services are rendered and adjusted in future periods as adjustments become known. This amount shall be equal to the amount presented in the most current audited financial statement as filed with the council.
"Publicly funded health care program." Care or services rendered by a government entity or any facility thereof or health care services for which payment is made directly or indirectly by a government entity, including, but not limited to, Medicare and medical assistance, or by their fiscal intermediary.
"Qualified hospital." An eligible hospital which has an uncompensated care score at or exceeding the median score of all eligible hospitals.
"Uncompensated care." The cost of care provided to patients financially unable or unwilling to pay for services provided by a hospital. This cost shall be determined by the council utilizing reported data and the hospital's cost-to-charge ratio and shall include charity care expense and bad debt expense.
"Uninsured." An individual who has no health insurance coverage, whose coverage does not reimburse for the medically necessary services provided by a hospital or who does not receive benefits under a publicly funded health care program.
35 P.S. § 5701.1102