(7) For purposes of this subsection: (A) Each of the following shall be considered a separate class of health care items and services: (i) Inpatient hospital services. (ii) Outpatient hospital services. (iii) Nursing facility services (other than services of intermediate care facilities for the mentally retarded). (iv) Services of intermediate care facilities for the mentally retarded. (v) Physicians’ services. (vi) Home health care services. (vii) Outpatient prescription drugs. (viii) Services of managed care organizations (including health maintenance organizations, preferred provider organizations, and such other similar organizations as the Secretary may specify by regulation). (ix) Such other classification of health care items and services consistent with this subparagraph as the Secretary may establish by regulation. (B) The term “health care provider” means an individual or person that receives payments for the provision of health care items or services. (C) An entity is considered to be “related” to a health care provider if the entity— (i) is an organization, association, corporation or partnership formed by or on behalf of health care providers; (ii) is a person with an ownership or control interest (as defined in section 1320a–3(a)(3) of this title ) in the provider; (iii) is the employee, spouse, parent, child, or sibling of the provider (or of a person described in clause (ii)); or (iv) has a similar, close relationship (as defined in regulations) to the provider. (D) The term “State” means only the 50 States and the District of Columbia but does not include any State whose entire program under this subchapter is operated under a waiver granted under section 1315 of this title . (E) The “State fiscal year” means, with respect to a specified year, a State fiscal year ending in that specified year. (F) The term “tax” includes any licensing fee, assessment, or other mandatory payment, but does not include payment of a criminal or civil fine or penalty (other than a fine or penalty imposed in lieu of or instead of a fee, assessment, or other mandatory payment). (G) The term “unit of local government” means, with respect to a State, a city, county, special purpose district, or other governmental unit in the State.


42 USC § 1396b(w)(7)

Scoping language

For purposes of this subsection
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