Md. Code Regs. 10.14.05.02

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.14.05.02 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Annual family income" means the total amount received per year from all sources before taxes are withheld.

(2) "Applicant" means a person who has applied to receive a grant under the Maryland Cancer Fund.

(3) "Applied research" means research that is undertaken to determine:

(a) Possible uses for the findings of basic research; or

(b) New ways of achieving some specific objective.

(4) "Authorized representative" means an individual or organization that has received permission from an individual diagnosed with cancer to perform certain tasks on the individual's behalf.

(5) "Basic research" means experimental or theoretical work undertaken to acquire new knowledge or understanding of cancer.

(6) "Case management" means the coordination of services by a health care professional for an individual for cancer:

(a) Screening;

(b) Diagnosis; or

(c) Treatment.

(7) "Capital expenditures" means money spent to add or expand property, equipment, and assets that will benefit an organization in the long term.

(8) "Center for Cancer Prevention and Control (CCPC)" means a unit of the Department of Health and Mental Hygiene within the Prevention and Health Promotion Administration.

(9) "Clinical research" means research:

(a) Conducted primarily on patients; and

(b) Designed to answer questions about the etiology, prevention, early detection, diagnosis, or treatment of cancer.

(10) "Community-based participatory research" means a collaborative, partnership approach to research that equitably involves community members, organizational representatives, and researchers in all aspects of the research process.

(11) "Comptroller" means the Comptroller of the Treasury.

(12) "Coinsurance" means the percent of allowable charges for a medical service that an individual with health insurance is responsible for paying.

(13) "Copayment (copay)" means the set amount of money that an individual with health insurance is responsible for paying each time the individual receives a medical service.

(14) "County" means a county of this State or Baltimore City.

(15) "Current Procedure Terminology (CPT)" means the uniform descriptive terms and identifying codes for reporting medical services and procedures performed by physicians.

(16) "Deductible" means the amount of money that an individual with health insurance is required to pay before the individual's health insurance starts coverage.

(17) "Department" means the Department of Health and Mental Hygiene.

(18) "Diagnosis" means a histopathologic finding of cancer in a:

(a) Biopsy; or

(b) Surgical specimen.

(19) Educational Institution.

(a) "Educational institution" means an organization whose primary mission is to educate individuals.

(b) "Educational institution" includes:

(i) Private and public elementary schools;

(ii) Middle schools;

(iii) High schools;

(iv) Colleges;

(v) Universities;

(vi) Graduate schools; and

(vii) Research institutions.

(20) "Family" means the unit comprised of all of the following that apply:

(a) For a financially independent adult 18 years old or older diagnosed with cancer, the adult diagnosed with cancer or the adult diagnosed with cancer and one or more of the following:

(i) Spouse;

(ii) Financially dependent child; or

(iii) Financially dependent relative; or

(b) For a financially dependent child, the child and one or more of the following:

(i) Parent, foster parent, or guardian;

(ii) Sibling living in the household; or

(iii) Half brother or half sister living in the household.

(21) "Federal poverty level" means the poverty guidelines, as amended, which are updated periodically in the Federal Register by the U.S. Department of Health and Human Services and which are incorporated by reference by COMAR 10.11.03.01"1.

(22) "Fund" means the Maryland Cancer Fund.

(23) Grant.

(a) "Grant" means financial assistance from the State to support an applicant's activities related to cancer:

(i) Research;

(ii) Primary prevention;

(iii) Secondary prevention; and

(iv) Treatment.

(b) "Grant" does not mean a contract.

(24) "Governmental entity" means a federal, State, or local governmental organization.

(25) "Health Services Cost Review Commission (HSCRC)" means the independent organization within the Department that is responsible for reviewing and approving rates for hospitals pursuant to Health-General Article, Title 19, Subtitle 2, Annotated Code of Maryland.

(26) "Hospital" means an institution that:

(a) Operates within the jurisdiction of Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland; and

(b) Is licensed pursuant to COMAR 10.07.01 or other applicable standards established by the jurisdiction in which the service is provided.

(27) "Laboratory" means a licensed or certified facility operated for the examination of material derived from the human body for the purpose of obtaining information for the diagnosis, treatment, and management of a disease.

(28) "Local health department" means a governmental entity in a county in Maryland that provides public health services.

(29) "Major medical equipment" means equipment that:

(a) Costs in excess of $500; and

(b) Is used for the provision of medical or health services.

(30) "Maryland Comprehensive Cancer Control Plan" means the most recent edition of the cancer plan developed by the Department.

(31) "Maryland Health Insurance Plan (MHIP)" means a State-administered program that:

(a) Is operated by a unit within the Maryland Insurance Administration under Insurance Article, Title 14, Subtitle 5, Annotated Code of Maryland; and

(b) Provides health insurance coverage to medically uninsurable Maryland residents.

(32) "Medical Assistance" means the program administered by the State under Title XIX of the Social Security Act, 42 U.S.C. §§ 1396- 1396v, which provides comprehensive medical and other health-related care for eligible categorically and medically needy persons.

(33) "Medicare" means the medical insurance program administered by the federal government under Title XVIII of the Social Security Act, 42 U.S.C. §§ 1395- 1395hhh.

(34) "Patient contribution amount" means the amount of money required by an individual's health insurance policy to be paid by the individual for a given medical procedure or service received, excluding the deductible.

(35) "Physician" means an individual who is licensed to practice medicine in the jurisdiction in which the service is provided.

(36) "Premium" means the amount of money than an individual pays in regular installments to a health insurer for a health insurance policy.

(37) Primary Prevention.

(a) "Primary prevention" means activities to prevent or reduce the development of cancer.

(b) "Primary prevention" includes interventions such as:

(i) Tobacco use prevention and cessation;

(ii) Protection from ultraviolet light;

(iii) Proper nutrition and physical activity; and

(iv) Reduction of exposure to environmental and occupational carcinogens.

(38) Research.

(a) "Research" means activities to develop or advance the understanding of cancer or the techniques or modalities effective in the prevention, cure, screening, diagnosis, or treatment of cancer.

(b) "Research" includes basic, clinical, applied, translational, and community-based participatory research.

(39) "Secondary prevention" means activities to detect and diagnose cancer in its early stages, when the chances of treatment and control are the greatest.

(40) "Secretary" means the Secretary of Health and Mental Hygiene.

(41) "Translational research" means using or applying new discoveries to benefit patient care.

(42) "Treatment" means the medical management and care of a patient that is provided for:

(a) Obtaining a cancer diagnosis, determining the full extent of the cancer spread, or treating the cancer, including:

(i) Surgery;

(ii) Chemotherapy;

(iii) Radiation therapy;

(iv) Hormonal therapy;

(v) Biopsy;

(vi) Imaging procedures;

(vii) Laboratory testing;

(viii) Home health services; and

(ix) Medical supplies or medical equipment;

(b) Treating medical complications resulting from cancer screening or treatment;

(c) Treating other co-morbid conditions in order to treat cancer; or

(d) Providing palliative or end-of-life care.

(43) "Uninsured" means that an individual:

(a) Does not have any health insurance; or

(b) Has health insurance that does not cover the cancer prevention, screening, diagnosis, or treatment services provided under the Fund.

Md. Code Regs. 10.14.05.02

Regulations.02 adopted as an emergency provision effective June 1, 2006 (33:15 Md. R. 1274); adopted permanently effective October 9, 2006 (33:20 Md. R. 1616)
Regulation .02B amended as an emergency provision effective June 12, 2008 (35:14 Md. R. 1243); amended permanently effective October 20, 2008 (35:21 Md. R. 1824)
Regulation .02B amended as an emergency provision effective December 22, 2008 (36:2 Md. R. 97); amended permanently effective April 6, 2009 (36:7 Md. R. 524)
Regulation .02B amended effective 40:5 Md. R. 411, eff. 3/18/2013
Regulation .02B amended as an emergency provision effective 41:2 Md. R. 88, eff.1/1/2014 ; amended permanently effective41:9 Md. R. 521, eff.5/12/2014