249J.3 - DEFINITIONS.
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