Md. Code Regs. 10.14.06.02 - Definitions
A. In this chapter,
the following terms have the meanings indicated.
B. Terms Defined.
(12)
(11) "Statewide academic health center " means:
(14)
(13) "Tobacco
treatment product" means all Food and Drug Administration -approved tobacco
cessation medications, including both prescription and over-the-counter
medications, that assist individuals to stop using tobacco products.
(1) "Applicant " means an individual who has
applied to receive cancer treatment services or tobacco treatment products
under this chapter.
(2) "Cancer
Prevention, Education, Screening, and Treatment Program " means the program
created by Health-General Article, §§
13-1101
-13-1119, Annotated Code of Maryland, to provide cancer prevention, education,
screening, and treatment services in Maryland.
(3) "Cancer treatment service" means a
medical service or, medical supply, or
medical equipment provided to:
(a) Treat
cancer, including:
(i) Surgery;
(ii) Chemotherapy;
(iii) Radiation therapy;
(iv) Hormonal therapy;
(v) Home health services; and
(vi) Medical supplies and medical
equipment;
(b) Treat
medical complications resulting from cancer screening or treatment ;
(c) Treat other comorbid conditions in order
to treat cancer; and
(d) Serve the
needs of cancer patients for palliative or end-of-life care.
(4) "Department " means the
Maryland Department of Health and Mental Hygiene.
(5) "Federal poverty level " means the amount
of household income by family size that a family needs for basic necessities as
determined by the federal poverty guidelines, as amended, which are updated
annually in the Federal Register by the U.S. Department of Health and Human
Services.
(6) "Gross annual
household income " means the total income of the applicant and any member of the
applicant 's household received each year from all sources before taxes are
withheld or deductions are taken.
(7) "Local health department " means a
governmental entity in a county in Maryland that provides public health
services.
(8) "Maryland Children's
Health Insurance Program " means the program administered by Medical Assistance
to provide health insurance coverage to eligible children younger than 19 years
old in Maryland.
(9) "Medical
Assistance " means the program that:
(a)
Provides comprehensive medical and other health-related care for eligible
individuals; and
(10)
"Medicare " means the medical insurance program administered by the federal
government under Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et
seq.
(a) The University of Maryland Medical
Group;
(b) The Johns Hopkins
Institutions;
(c) The organization
designated by the Department as stipulated by Health-General Article, §
13-1115,
Annotated Code of Maryland; or
(d)
One or more of the organizations in §B(ll)(a)-(c) of this regulation.
(12) "Tobacco product " means
cigarettes, cigars, pipe tobacco, smokeless tobacco, and any other product
containing tobacco in any form.
(14) "Tobacco Use Prevention and Cessation
Program " means the program created by Health-General Article, §§
13-1001
-13-1014, Annotated Code of Maryland, to provide tobacco use prevention and
cessation services in Maryland.
(15)
"Underinsured " individual means an applicant :
(a) Who has private medical insurance,
Medical Assistance , Medicare, or Maryland Children's Health Insurance Program
coverage;
(b) For whom the
appropriate treatment is not adequately covered due to out-of-pocket costs
including:
(i) Copayments;
(ii) Coinsurance; or
(iii) Deductibles; and
(c) Who the Department determines does not
have the financial means to pay for appropriate treatment.
(16) "Uninsured " individual means an
applicant who:
(a) Either:
(i) Does not have private medical insurance,
Medical Assistance , Medicare, or Maryland Children's Health Insurance Program
coverage; or
(ii) Has private
medical insurance, Medical Assistance , Medicare, or Maryland Children's Health
Insurance Program coverage that does not provide insurance coverage for
medically necessary services for a cancer treatment service or tobacco
treatment product; and
(b) Does not have the financial means to pay
for a cancer treatment service or tobacco treatment product as defined by the
criteria established in this chapter.
(17) "University of Maryland Medical Group
(UMMG) " means the University of Maryland Medical Systems Corporation, the
University of Maryland Medical School, and the University of Maryland,
Baltimore.
Notes
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