56-252. DEFINITIONS. As used in sections 56-250 through 56-255, Idaho Code:
(1) "Benchmark plan" means a package of health benefits coverage that provides coverage for a specified population in accordance with section 6044 of the deficit reduction act of 2005.
(2) "Benefit design" means selection of services, providers and beneficiary cost-sharing to create the scope of coverage for participants.
(3) "Community supports" means services that promote the ability of persons with disabilities to be self-sufficient and live independently in their own communities.
(4) "Cost-sharing" means participant payment for a portion of medicaid service costs such as deductibles, coinsurance or copayment amounts.
(5) "Department" means the department of health and welfare.
(6) "Director" means the director of the department of health and welfare.
(7) "Health risk assessment" means a process of assessing the health status and health needs of participants.
(8) "Medicaid" means Idaho’s medical assistance program.
(9) "Medical assistance" means payments for part or all of the cost of services funded by titles XIX or XXI of the federal social security act as amended, as may be designated by department rule.
(10) "Medical home" means a primary care case manager designated by the participant or the department to coordinate the participant’s care.
(11) "Network management" means establishment and management of contracts between the department and limited groups of providers or suppliers of medical and other services to participants.
(12) "Participant" means a person eligible for and enrolled in the Idaho medical assistance program.
(13) "Premium assistance" means use of medicaid funds to pay part or all of the costs of enrolling eligible individuals into private insurance coverage.
(14) "Primary care case manager" means a primary care physician who contracts with medicaid to coordinate the care of certain participants.
(15) "Provider" means any individual, partnership, association, corporation or organization, public or private, which provides residential or assisted living services, certified family home services, nursing facility services or services offered pursuant to medical assistance.
(16) "Self-determination" means medicaid services that allow persons with disabilities to exercise choice and control over the services and supports they receive.
(17) "State plan" means the contract between the state and federal government under 42 U.S.C. section 1396a(a).
History:
[56-252, added 2006, ch. 278, sec. 1, p. 854; am. 2007, ch. 200, sec. 2, p. 611.]
Structure Idaho Code
Title 56 - PUBLIC ASSISTANCE AND WELFARE
Chapter 2 - PUBLIC ASSISTANCE LAW
Section 56-202 - DUTIES OF DIRECTOR OF STATE DEPARTMENT OF HEALTH AND WELFARE.
Section 56-203 - POWERS OF STATE DEPARTMENT.
Section 56-203A - AUTHORITY OF DEPARTMENT TO ENFORCE CHILD SUPPORT — SUPPORT ENFORCEMENT SERVICES.
Section 56-203C - POWERS OF DEPARTMENT.
Section 56-203D - SET-OFF PROCEDURE FOR CHILD SUPPORT DEBT.
Section 56-203E - LOTTERY PRIZE SET-OFF PROCEDURE FOR SUPPORT DEBT.
Section 56-203F - REGISTRATION OF FOREIGN SUPPORT ORDERS.
Section 56-204A - SERVICES FOR CHILDREN.
Section 56-204B - TEMPORARY SHELTER CARE.
Section 56-205 - ISSUANCE OF SNAP BENEFITS.
Section 56-206 - GENERAL ASSISTANCE.
Section 56-207 - OLD-AGE ASSISTANCE.
Section 56-208 - AID TO THE BLIND.
Section 56-209 - ASSISTANCE TO FAMILIES WITH CHILDREN.
Section 56-209a - AID TO THE DISABLED.
Section 56-209b - MEDICAL ASSISTANCE — MEDICAL ASSISTANCE ACCOUNT.
Section 56-209c - DENIAL OF PAYMENT FOR ABORTIONS UNDER CERTAIN CONDITIONS.
Section 56-209e - ELIGIBILITY OF MARRIED COUPLES FOR MEDICAL ASSISTANCE UNDER THE MEDICAID PROGRAM.
Section 56-209f - STATE FINANCIAL ASSISTANCE PROGRAM FOR MEDICALLY INDIGENT RESIDENTS.
Section 56-209g - PHARMACY REIMBURSEMENT.
Section 56-209h - ADMINISTRATIVE REMEDIES.
Section 56-209i - LEGISLATIVE FINDINGS.
Section 56-209j - SUBSTANCE ABUSE SCREENING AND TESTING PROGRAMS.
Section 56-209l - TREATMENT PROVISIONS.
Section 56-209n - MEDICAID FOR WORKERS WITH DISABILITIES.
Section 56-209o - FAILURE TO RETAIN RECORDS.
Section 56-209p - PAYMENT FOR MIDWIFE SERVICES.
Section 56-210 - AMOUNT OF ASSISTANCE.
Section 56-211 - APPLICATION FOR PUBLIC ASSISTANCE — VERIFICATION FOR FEDERAL FOOD STAMP PROGRAM.
Section 56-212 - INVESTIGATION OF APPLICATION.
Section 56-213 - EXAMINATION TO DETERMINE BLINDNESS.
Section 56-214 - AWARD OF PUBLIC ASSISTANCE — INELIGIBILITY UPON TRANSFER OF PROPERTY.
Section 56-214A - AWARD OF PUBLIC ASSISTANCE — RECIPIENT’S RIGHT OF FREE CHOICE.
Section 56-215 - REDETERMINATION OF AWARDS.
Section 56-216 - APPEAL AND FAIR HEARING.
Section 56-217 - COOPERATIVE AGREEMENTS.
Section 56-218 - RECOVERY OF CERTAIN MEDICAL ASSISTANCE.
Section 56-218A - MEDICAL ASSISTANCE LIENS DURING LIFE OF RECIPIENT.
Section 56-219 - PAYMENT FOR INCOMPETENT RECIPIENT — APPOINTMENT OF GUARDIAN FOR PUBLIC ASSISTANCE.
Section 56-220 - PAYMENT ON DEATH OF RECIPIENT — APPOINTMENT OF ADMINISTRATOR OF PUBLIC ASSISTANCE.
Section 56-221 - CONFIDENTIAL CHARACTER OF PUBLIC ASSISTANCE RECORDS.
Section 56-222 - MISUSE OF PUBLIC ASSISTANCE LISTS AND RECORDS.
Section 56-223 - PUBLIC ASSISTANCE NOT ASSIGNABLE.
Section 56-225 - REQUEST FOR NOTICE OF TRANSFER OR ENCUMBRANCE OF REAL PROPERTY — RULEMAKING.
Section 56-226 - MEDICAID FRAUD CONTROL UNIT.
Section 56-227 - FRAUDULENT ACTS — PENALTY.
Section 56-227A - PROVIDER FRAUD — CRIMINAL PENALTY.
Section 56-227B - PROVIDER FRAUD — DAMAGES.
Section 56-227C - SUBPOENA POWER.
Section 56-227E - OBSTRUCTION OF INVESTIGATION.
Section 56-227F - PUBLIC ASSISTANCE BENEFIT CARDS — PROHIBITED USES.
Section 56-228 - LIMITATIONS OF ACT.
Section 56-229 - SEPARABILITY.
Section 56-233 - PROCEDURE FOR DISBURSEMENT OF FUNDS TO RECIPIENTS.
Section 56-234 - LEGISLATIVE INTENT.
Section 56-234A - DEFINITIONS.
Section 56-235 - SOUTHWEST IDAHO TREATMENT CENTER.
Section 56-235A - PROHIBITIONS, RESTRICTIONS AND LIMITATIONS ON ADMISSION.
Section 56-235B - DISCHARGE PLANNING — AUTHORIZATION TO DISCHARGE.
Section 56-235C - NOTICE OF DISCHARGE — REQUEST FOR HEARING.
Section 56-235E - RULEMAKING AUTHORITY.
Section 56-251 - LEGISLATIVE INTENT.
Section 56-253 - POWERS AND DUTIES OF THE DIRECTOR.
Section 56-254 - ELIGIBILITY FOR MEDICAL ASSISTANCE.
Section 56-255 - MEDICAL ASSISTANCE PROGRAM — SERVICES TO BE PROVIDED.
Section 56-256 - PREVENTIVE HEALTH ASSISTANCE.
Section 56-261 - LEGISLATIVE FINDINGS AND INTENT.
Section 56-263 - MEDICAID MANAGED CARE PLAN.
Section 56-264 - RULEMAKING AUTHORITY.
Section 56-265 - PROVIDER PAYMENT.
Section 56-266 - AUTHORIZATION TO OBTAIN FEDERAL APPROVAL.
Section 56-267 - MEDICAID ELIGIBILITY EXPANSION.
Section 56-268 - SUPPLEMENTAL MEDICAID REIMBURSEMENT FOR GROUND EMERGENCY MEDICAL TRANSPORTATION.