D.C. Mun. Regs. tit. 22, r. 22-B3399
For the purposes of this chapter, the following terms shall have the meanings ascribed:
American Indian/Alaska Native - Any individual who is a member of any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or regional or village corporation as defined in, or established pursuant to, the Alaska Native Claims Settlement Act (85 Stat. 688; 43 U.S.C. §§ 1601et seq.), which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.
Applicant - An individual who is seeking an eligibility determination for the Alliance program through an application submission or a transfer from another insurance affordability program.
Application - The current version of the combined application for food, medical, and cash benefits, as made available electronically, telephonically, or by hardcopy.
Authorized Representative - Legally authorized individual able to consent on behalf of a prospective applicant.
Beneficiary - An individual who has been determined eligible and is currently receiving Alliance program benefits.
Certification Period - Alliance program eligibility is determined for a twelve (12) month period. This period is called a certification period.
Custodial Parent - A court order or binding separation, divorce, or custody agreement establishing physical custody controls; or if there is no such order or agreement or in the event of a shared custody agreement, the custodial parent is the parent with whom the child spends most nights pursuant to 42 C.F.R §§ 435.603(f)(2)(iii)(A)-(B).
Department -For the purposes of this chapter, the term "the Department" shall refer to the Department of Health Care Finance (DHCF) or its designee.
Eligibility determination - An approval or denial of eligibility as well as a renewal or termination of eligibility.
Fair Hearings - An administrative procedure that gives applicants and beneficiaries the opportunity to contest adverse decisions regarding eligibility and benefit determinations.
Federal Poverty Level- A measure of income levels updated periodically in the Federal Register by the Secretary of Health and Human Services under the authority of 42 U.S.C. Section 9902(2), as in effect for the applicable budget period used to determine an individual's eligibility for Medicaid in accordance with 42 C.F.R. §§ 435.603(h).
Household Composition - Determined by individuals living together and their relationships to one another. The composition of the household determines an individual's family size.
Household Income - The countable income of every individual included in an applicant or beneficiary's household.
Institution - Means Institution and Medical institution, as defined in 42 C.F.R. §§ 435.1010.
Limited or no-English proficiency - As defined by D.C. Official Code §§ 2-1931 (2012 Repl.) as the inability to adequately understand or to express oneself in the spoken or written English language.
Modified adjusted gross income- Income calculated using the financial methodologies used to determine modified adjusted gross income as defined in 26 U.S.C. §§ 36B(d)(2)(B) and 42 C.F.R. §§ 435.603.
Other lump sum payments - non-recurring payments that are not qualified lottery winnings or gambling winnings, and may include but not be limited to backpay, a retroactive benefit payment, state tax refund, or an insurance settlement.
Parent - A person who has a natural or biological, adopted, or step-child.
Parent mentor - as defined under 42 U.S.C. §§ 1397mm (f)(5).
Qualified lottery winnings - as defined under 42 U.S.C. §§ 1396a(e)(14)(K)(v).
Qualified lump sum income - as defined under §§ 1396a(e)(14)(K)(vi) (i.e., gambling winnings).
Renewal - Periodic review to evaluate continued eligibility for the Alliance program.
Resident - A person who is presently and voluntarily living in the District of Columbia, with the intention to continue living in the District of Columbia.
Self-Employed Simplified Employee Pension- A written plan that allows individuals to make contributions toward their own retirement and their employees' retirement without getting involved in a more complex qualified plan.
State - Includes any of the fifty (50) constituent political entities of the United States and the District of Columbia.
Tax dependent - Tax dependent has the same meaning as the term "dependent" under Section 152 of the Internal Revenue Code, as an individual for whom another individual claims a deduction for a personal exemption under §§ 151 of the Internal Revenue Code for a taxable year.
Voluntary Termination - A voluntary request by an applicant to terminate eligibility for the Alliance program.
D.C. Mun. Regs. tit. 22, r. 22-B3399