62 Pa. Stat. § 1403-D
The following words and phrases when used in this article shall have the meanings given to them in this section unless the context clearly indicates otherwise:
"Acute care hospital." A facility that provides inpatient and outpatient services, which may include an emergency department or intensive care unit.
"Authority." The Pennsylvania Rural Health Redesign Center Authority continued in section 1411-D.
"Board." The governing body of the authority.
"Conflict of interest." A situation in which a board member:
"Critical access hospital." As defined in 42 U.S.C. § 1395X (MM)(1) (relating to definitions) .
"Eligible hospital services." All inpatient and hospital-based outpatient items and services. The term shall exclude all other items and services, including the following:
"Fund." The Pennsylvania Rural Health Redesign Center Fund continued in section 1441-D.
"Global budget." The prospectively set annual budget that is the basis for payment for each participant rural hospital for eligible hospital services by participating payers.
"Global budget model." An innovative payment and service delivery model that is intended to reduce health care costs while maintaining access to care, improving the quality of care in rural counties and meeting the health needs of participant rural hospitals' local communities, and under which participating payers pay participant rural hospitals using a global budget methodology established by the authority.
"Government program." A health benefit plan offered or administered by or on behalf of the United States or the Commonwealth or an agency or instrumentality of either, including:
"Insurer." A person, corporation or other entity licensed by the Commonwealth with authority to offer, issue or renew an insurance policy, subscriber contract or certificate providing health care coverage, including:
"Medicaid managed care organization." An entity as defined in 42 U.S.C. § 1396B (M)(1)(A) (relating to payment to states) that is a party to an agreement with the department, including a county Medicaid managed care organization and a permitted assignee of an agreement. The term does not include an assignor of an agreement.
"Participant rural hospital." A rural hospital that has been selected and signs an agreement to participate in the global budget model.
"Participating payer." A payer that operates in rural counties and, with respect to one or more specified products, programs or payment arrangements, signs an agreement with the authority to participate in the global budget model.
"Payer." An insurer, government program or Medicaid managed care organization that pays or administers payment for health care services under an insurance policy, subscriber contract, certificate, administrative services arrangement or other payment arrangement.
"Rural county." A county within this Commonwealth where the population density is less than 284 persons per square mile as defined by the Center For Rural Pennsylvania, established under section 301 of the act of June 30, 1987 ( P.L. 163, No.16), known as the Rural Pennsylvania Revitalization Act.
"Rural hospital." An acute care hospital or critical access hospital located in a rural county.
"Rural hospital transformation plan." A description of the health care delivery system transformation that a participant rural hospital will undergo under the global budget model, as approved by the board and the Federal government.
"Swing bed." A hospital bed that has been approved by the Medicare program established under under 42 U.S.C. Ch. 7 subch. XVIII to provide posthospital skilled nursing facility care when the rural hospital participates in the Medicare program.
62 P.S. § 1403-D