R590-237-4 - Definitions

R590-237-4. Definitions

In addition to the definitions in Sections 31A-1-301, 31A-8-101, and 31A-45-102, the following definitions apply for the purposes of this rule:

(1) "Board of directors" means the local board of directors for the independent hospital that is directly responsible for the daily policy and financial decisions. A board of directors does not include a corporate board of directors for the entity that owns the independent hospital.

(2) "Local practice location" means the provider's office where services are rendered.

(a) The local practice location is permanently located within a county with a population density of:

(i) less than 100 people per square mile prior to December 31, 2000; or

(ii) less than 30 people per square mile.

(b) The local practice location is within 30 miles of paved roads of:

(i) the place where the enrollee lives or resides; or

(ii) the location of the independent hospital or federally qualified health center at which the enrollee may receive covered benefits pursuant to Subsections 31A-45-501(2) or 31A-45-501(3).

(3) "Policy and financial decisions" means the day-to-day decisions made by the local board of directors with regard to an independent hospital's policy and financial solvency.

(4) "Provider" means a person who:

(a) furnishes health care directly to the enrollee; and

(b) is licensed or otherwise authorized to furnish the health care in Utah.

(5) "Referral" means:

(a) the request by a health care provider for an item, service, test, or procedure to be performed by another health care provider;

(b) the request by a physician for a consultation with another physician; or

(c) the request or establishment of a plan of care by a physician.

(6) "Rural county" means a county with a population density of less than 100 people per square mile.

(Amended by Utah State Bulletin Number 2020-15, effective 7/22/2020)

The following state regulations pages link to this page.