Tenn. Comp. R. & Regs. 1200-20-11-.02 - DEFINITIONS

As used in these rules, the terms below shall have the following meanings:

(1) Complete application - submittal, by certified mail, of all forms and information outlined by the Department in the policies and procedures for the State Conrad J-1 Visa Waiver Program to the Nashville, Tennessee office of the State Conrad J-1 Visa Waiver Program.
(2) Conrad Waiver - see State Conrad J-1 Visa Waiver Program.
(3) Critical Access Hospital (CAH) - a federally designated hospital that is very small with staffing flexibility under Medicare rules for providing emergency, outpatient, and short-stay inpatient services.
(4) Department - Tennessee Department of Health.
(5) Health Professional Shortage Area (HPSA) - a geographical area designated by the Secretary of the U.S. Department of Health and Human Services as having a shortage of health manpower (formerly Health Manpower Shortage Area).
(6) Health Resource Shortage Area (HRSA) - an area designated annually by the Commissioner of the Department as having inadequate resources in place to ensure access to primary, pediatric, obstetric or TennCare Services. It includes State designated Health Resource Shortage Areas for Primary, Pediatric, Obstetrical Care and TennCare.
(7) Indigent patients - patients who are at or below two-hundred percent (200%) of the federal poverty level with no comprehensive third-party coverage.
(8) Managed Care Organization (MCO) - an entity rendering or arranging necessary medical services to persons who are eligible for Medicaid or TennCare Standard and who are enrolled in the TennCare managed care program. MCO's are paid by the State of Tennessee authorized and consistent with a Section 1115 waiver of the Social Security Act granted by the Health Care Financing Administration (renamed in 2001 as the "Centers for Medicare and Medicaid Services or "CMS"), U.S. Department of Health and Human Services.
(9) Medicare Dependent Hospital - a federally designated hospital that is a small rural hospital for which Medicare patients comprise a significant percentage of their patients and their revenues.
(10) Medically Underserved Area (MUA) - a geographical area which is designated by the Secretary of the U.S. Department of Health and Human Services as having a shortage of health care services using several factors, in addition to the availability of health care providers, including infant mortality rate, poverty rate, and percentage of population aged sixty five (65) or over.
(11) Primary care physician - a physician who has completed a residency in Family Practice, General Pediatrics, Obstetrics, or General Internal Medicine and who is also supported by a sponsoring employer.
(12) Primary health care - services which emphasize first contact patient care. The provider assumes overall and ongoing responsibility for the patient in both health maintenance and treatment of illness, emphasizing continuity of care over the entire spectrum of health care services.
(13) Physician specialist - a physician who has completed a residency in Family Practice Adolescent Medicine or Geriatric Medicine; or Internal Medicine Adolescent Medicine, Cardiovascular Disease, Critical Care Medicine, Endocrinology, Diabetes, & Metabolism, Emergency Medicine, Gastroenterology, Geriatric Medicine, Hematology, Hospitalists, Infectious Disease, Interventional Cardiology, Oncology, Nephrology, Neurology, Pulmonary Disease, Rheumatology; or Obstetrics & Gynecology Critical Care Medicine or Gynecologic Oncology; or Pediatric Adolescent Medicine, Developmental-Behavioral Pediatrics, Pediatric Cardiology, Pediatric Endocrinology, Pediatric Gastroenterology, Pediatric Hematology-Oncology, Pediatric Infectious Disease, Pediatric Nephrology, Pediatric Pulmonology, or Pediatric Critical Care Medicine; or Addiction Psychiatry, Child & Adolescent Psychiatry, or Geriatric Psychiatry; or General Orthopedic Surgery or General Surgery. If all slots permitted by federal law are not filled by June 30th of each year, at the Commissioner's discretion, a "specialist" may also include a physician who has completed a residency in a medical specialty or subspecialty other than one listed above, if the specialty or subspecialty is among those recognized by the American Board of Medical Specialties at the time the physician applies for placement through the J-1 visa waiver program.
(14) Rural areas - all counties in Tennessee, excluding Shelby, Davidson, Knox and Hamilton.
(15) Rural Hospital - a federally designated hospital meeting the requirements for placement of primary care physicians. Rural Hospitals which are located in counties containing federally designated health professional shortage areas (HPSAs) and/or medically underserved areas (MUAs), either of which must also be located within the top thirty (30) state designated health resource shortage areas (HRSAs) for TennCare, primary care, obstetrics or pediatrics.
(16) Rural Referral Center (RRC) - a federally designated hospital that is authorized under the Tax Equity and Fiscal Responsibility Act of 1982. These are rural hospitals with generally high volume whose costs more closely resemble those of urban hospitals because they treat regionally or nationally referred complex cases.
(17) Sole Community Hospital (SCH) - a federally designated hospital that is the only provider of hospital care in its market area either because it is geographically isolated or because severe weather or travel conditions prevent travel to another hospital offering similar services.
(18) Sponsoring employer - a health care facility or physician practice located in qualifying communities which provides primary health care to underserved residents. Examples of these facilities are hospitals, primary care clinics, community health clinics, local health departments, or private physician offices which routinely accept TennCare and indigent patients.
(19) State Conrad J-1 Visa Waiver Program - the enactment of the Immigration and Nationality Technical Corrections Act of 1994 ( Pub. L. 103-416 ) has provided an additional basis upon which a foreign medical graduate may seek a waiver of the two-year home residence requirement. Section 220(a) of that Act added a provision that authorizes a State Department of Public Health or its equivalent to request the Director of the United States Information Agency to recommend that Immigration and Naturalization Service grant the waiver.


Tenn. Comp. R. & Regs. 1200-20-11-.02
Original rule filed May 30, 1997; effective September 28, 1997. Repeal and new rule filed April 28, 2000; effective July 12, 2000. Amendment filed January 31, 2003; effective May 30, 2003. Repeal and new rule filed December 12, 2003; effective February 25, 2004. Amendments filed January 12, 2005; effective May 31, 2005. Public necessity rules filed May 19, 2006; effective through October 31, 2006. Amendments filed May 31, 2006; effective September 28, 2006.

Authority: T.C.A. ยงยง 4-5-202, 4-5-204, 68-1-103, 68-1-121, Public Acts of 2003; Chapter 117, and Public Acts of 2004, Chapter 572.

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