§ 40-8-2 - Definitions.
SECTION 40-8-2
§ 40-8-2 Definitions. – As used in this chapter, unless the context shall otherwise require:
(1) "Dental service" means and includes emergency care,X-rays for diagnoses, extractions, palliative treatment, and the refitting andrelining of existing dentures and prosthesis.
(2) "Department" means the department of human services.
(3) "Director" means the director of human services.
(4) "Drug" means and includes only such drugs and biologicalsprescribed by a licensed dentist or physician as are either included in theUnited States pharmacopoeia, national formulary, or are new and nonofficialdrugs and remedies.
(5) "Inpatient" means a person admitted to and undertreatment or care of a physician or surgeon in a hospital or nursing facilitywhich meets standards of and complies with rules and regulations promulgated bythe director.
(6) "Inpatient hospital services" means the following itemsand services furnished to an inpatient in a hospital other than a hospital,institution or facility for tuberculosis or mental diseases:
(i) Bed and board;
(ii) Such nursing services and other related services as arecustomarily furnished by the hospital for the care and treatment of inpatientsand such drugs, biologicals, supplies, appliances, and equipment for use in thehospital, as are customarily furnished by the hospital for the care andtreatment of patients;
(iii) Such other diagnostic or therapeutic items or services,including, but not limited to, pathology, radiology, and anesthesiologyfurnished by the hospital or by others under arrangements made by the hospital,as are customarily furnished to inpatients either by the hospital or by othersunder such arrangements, and services as are customarily provided to inpatientsin the hospital by an intern or resident-in-training under a teaching programhaving the approval of the Council on Medical Education and Hospitals of theAmerican Medical Association or of any other recognized medical societyapproved by the director.
(B) The term "inpatient hospital services" shall be taken toinclude medical and surgical services provided by the inpatient's physician,but shall not include the services of a private duty nurse or services in ahospital, institution, or facility maintained primarily for the treatment andcare of patients with tuberculosis or mental diseases. Provided, further, itshall be taken to include only the following organ transplant operations:kidney, liver, cornea, pancreas, bone marrow, lung, heart, and heart/lung, andsuch other organ transplant operations as may be designated by the directorafter consultation with medical advisory staff or medical consultants; andprovided that any such transplant operation is determined by the director orhis or her designee to be medically necessary. Prior written approval of thedirector or his or her designee shall be required for all covered organtransplant operations.
(C) In determining medical necessity for organ transplantprocedures, the state plan shall adopt a case-by-case approach and shall focuson the medical indications and contra-indications in each instance, theprogressive nature of the disease, the existence of any alternative therapies,the life threatening nature of the disease, the general state of health of thepatient apart from the particular organ disease, and any other relevant factsand circumstances related to the applicant and the particular transplantprocedure.
(7) "Nursing services" means the following items and servicesfurnished to an inpatient in a nursing facility:
(i) Bed and board;
(ii) Such nursing care and other related services as arecustomarily furnished to inpatients admitted to the nursing facility, and suchdrugs, biologicals, supplies, appliances, and equipment for use in thefacility, as are customarily furnished in the facility for the care andtreatment of patients;
(iii) Such other diagnostic or therapeutic items or services,legally furnished by the facility or by others under arrangements made by thefacility, as are customarily furnished to inpatients either by the facility orby others under such arrangement;
(iv) Medical services provided in the facility by theinpatient's physician, or by an intern or resident-in-training of a hospitalwith which the facility is affiliated or which is under the same control, undera teaching program of the hospital approved as provided in subsection (6) ofthis section; and
(v) A personal needs allowance of fifty dollars ($50.00) permonth.
(8) "Relative with whom such dependent child is living" meansand includes the father, mother, grandfather, grandmother, brother, sister,stepfather, stepmother, stepbrother, stepsister, uncle, aunt, first cousin,nephew, or niece of any dependent child who maintains a home for the dependentchild.
(9) "Visiting nurse service" means part-time or intermittentnursing care provided by or under the supervision of a registered professionalnurse other than in a hospital or nursing home.