D.C. Mun. Regs. tit. 29, r. 29-10299
Beneficiary - An individual deemed eligible for and in receipt of services provided through the District Medicaid program.
Corporate Entity - An organization that holds a single Employer Identification Number, as defined in 26 CFR § 301.7701-12.
Fair Hearing - A procedure whereby the District provides an opportunity for a hearing to any person whose claim for assistance is denied consistent with the requirements set forth in 42 CFR §§ 431.200et seq.
Federally Qualified Health Center - An organization that meets the definition set forth in Section 1905(l)(2)(B) of the Social Security Act ( 42 USC § 1396d(1)(2)(B) ).
District Fiscal Year - A twelve (12) month period beginning on October 1st and ending on September 30th.
Hybrid Data - A combination of administrative data (i.e. claims, encounters, and vital records) and clinical data contained in medical records.
My Health GPS Entity - A primary care clinical individual practice, primary care clinical group practice, or Federally Qualified Health Center currently enrolled as a District Medicaid provider that incorporates a My Health GPS provider into its primary care service delivery structure.
My Health GPS Provider - An approved interdisciplinary team that delivers My Health GPS services within a My Health GPS entity.
Opt Out - The process by which a beneficiary chooses not to participate in the My Health GPS program.
Outreach - Active and progressive attempts at beneficiary engagement, including direct communication (i.e. face-to-face, mail, email, telephone) with the beneficiary or the beneficiary's designated representative.
Performance Period - A full District fiscal year, beginning in Fiscal Year 2019.
Sentinel Event - Any unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a patient and which is not related to the natural course of the patient's illness.
Transition Record- The document containing information regarding a patient's diagnosis and treatment received during an inpatient stay that is transmitted to relevant providers following the patient's discharge.
D.C. Mun. Regs. tit. 29, r. 29-10299