D.C. Mun. Regs. tit. 29, r. 29-7399
When used in this chapter, the following terms and phrases shall have the following meanings:
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 medical assistance in the Immigrant Children's Program through an application submission.
Authorized representative - A legally authorized individual or entity able to consent on behalf of a prospective applicant or beneficiary.
Beneficiary - An individual who has been determined eligible and is currently receiving medical assistance in the Immigrant Children's Program.
Certification period -The twelve (12)-month period used to determine eligibility for the Immigrant Children's Program. This period is called a certification period.
Custodial parent - A person who, by court order or binding separation, divorce, or custody agreement, is established as having physical custody controls; or if there is no such order or agreement or in the event of a shared custody agreement, the parent with whom the child spends most nights pursuant to 42 C.F.R § 435.603(f)(2)(iii)(A)-(B).
Department - 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 (FPL) - A measure of income level issued annually by the U.S. Department of Health and Human Services, used to determine eligibility for medical assistance programs, including the Immigrant Children's Program, in the District.
Household composition - An individual's family size as determined by individuals living together and their relationships to one another.
Household income - The countable income of every individual included in an applicant or beneficiary's household.
Immigrant child - Any child who is ineligible for Medicaid by virtue of the child's immigration status.
Institution - The same meaning as defined in 42 C.F.R. § 435.1010.
Limited or no-English proficiency - The inability to adequately understand or to express oneself in the spoken or written English language, as defined by D.C. Official Code § 2-1931.
Medical assistance - Health care services provided by an MCO in accordance with the terms of a contract between the District government and the MCO to provide managed care health services on a capitated basis.
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, which may include backpay, a retroactive benefit payment, a state tax refund, or an insurance settlement.
Public institution - The same meaning as defined in 42 C.F.R. § 435.1010.
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 42 U.S.C. § 1396a(e)(14)(K)(vi) (i.e., gambling winnings).
Renewal - Annual review to evaluate continued eligibility for medical assistance in the Immigrant Children's 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.
Sibling - Each of two (2) or more children or offspring having one (1) or both natural, biological, adopted, or step-parents in common.
State - Any of the fifty (50) states of the United States and the District of Columbia.
Tax dependent - An individual for whom another individual claims a deduction for a personal exemption under Section 151 of the Internal Revenue Code for a taxable year, as defined by D.C. Official Code § 2-1931.
D.C. Mun. Regs. tit. 29, r. 29-7399