249J.3 - DEFINITIONS. - Iowa Statutes

249J.3 DEFINITIONS. As used in this chapter, unless the context otherwise requires: 1. "Clean claim" means a claim submitted by a provider included in the expansion population provider network that may be adjudicated as paid or denied. 2. "Department" means the department of human services. 3. "Director" means the director of human services. 4. "Expansion population" means the individuals who are eligible solely for benefits under the medical assistance program waiver as provided in this chapter. 5. "Full benefit dually eligible Medicare Part D beneficiary" means a person who is eligible for coverage for Medicare Part D drugs and is simultaneously eligible for full medical assistance benefits pursuant to chapter 249A, under any category of eligibility. 6. "Full benefit recipient" means an adult who is eligible for full medical assistance benefits pursuant to chapter 249A under any category of eligibility. 7. "Iowa Medicaid enterprise" means the centralized medical assistance program infrastructure, based on a business enterprise model, and designed to foster collaboration among all program stakeholders by focusing on quality, integrity, and consistency. 8. "Medical assistance" or "Medicaid" means payment of all or part of the costs of care and services provided to an individual pursuant to chapter 249A and Title XIX of the federal Social Security Act. 9. "Medicare Part D" means the Medicare Part D program established pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Pub. L. No. 108-173. 10. "Minimum data set" means the minimum data set established by the centers for Medicare and Medicaid services of the United States department of health and human services for nursing home resident assessment and care screening. 11. "Nursing facility" means a nursing facility as defined in section 135C.1. 12. "Public hospital" means a hospital licensed pursuant to chapter 135B and governed pursuant to chapter 145A, 226, 347, 347A, or 392.          Section History: Recent Form 2005 Acts, ch 167, §3, 66 Referred to in § 21.5, 97B.52A, 249K.2, 476B.1