Current through September 2, 2024
Section 17.10.01.010 - DEFINITIONS01.Crime Victim's Compensation Program ("CVCP"). The program administered by the Crime Victim's Division of the Idaho Industrial Commission pursuant to the Crime Victim's Compensation Act.02.Employer. The employer at the time of the criminally injurious conduct.03.Good Cause. "Good cause" as that term is found in the Crime Victim's Compensation Act will be determined at the Commission's discretion on a case-by-case basis.04.Medical Services. For purposes of the fee schedule adopted by the Commission as authorized by Section 72-1026, Idaho Code, the following terms apply: a. "Allowable payment" means the lower of the charge for medical services calculated in accordance with this rule or as billed by the provider.b. "Ambulatory Surgery Center (ASC)" means a facility providing surgical services on an outpatient basis only.c. "Hospital" is any acute care facility providing medical or rehabilitation services on an inpatient and outpatient basis. i. Large Hospital means any hospital with more than one hundred (100) acute care beds.ii. Small Hospital means any hospital with one hundred (100) acute care beds or less.d. "Provider" means any person, firm, corporation, partnership, association, agency, institution, or other legal entity providing any kind of medical service related to the treatment of a claimant for benefits under the Idaho Crime Victims Compensation Act.e. "Medical Service" means medical, surgical, dental, mental health, or other attendance or treatment, nurse and hospital service, medicine, apparatus, appliance, prostheses and related service, facility, equipment and supply.f. "Reasonable" means a charge does not exceed the Provider's "usual" charge and does not exceed the "customary" charge, as defined below.g. "Usual" means the most frequent charge made by an individual Provider for a given medical service.h. "Customary" means a charge that has an upper limit no higher than the 90th percentile, as determined by the Commission, of usual charges made by Idaho Providers for a given medical service.Idaho Admin. Code r. 17.10.01.010