Current through Register Vol. XLI, No. 50, December 13, 2024
Section 69-2-2 - Definitions2.1. As used in this legislative rule, the following terms, words, and phrases have the meanings stated below unless in any instance where such term, word, or phrase is employed the context clearly indicates that another meaning is intended.2.2. The term "Act" means the Omnibus Health Care Act which is codified at W. Va. Code § 16-29D-1 et seq., as amended.2.3. The terms "Code of West Virginia" and "West Virginia Code" mean the W. Va. Code of 1931, as amended.2.4. The term "coordination of benefits" means a provision which establishes an order in which two or more insurance contracts, plans or programs covering the same beneficiary pay their claims, with the effect that there is no duplication of benefits.2.5. The terms "health care", "health care services", or "health care treatments" mean clinically related preventive, diagnostic, treatment, or rehabilitative services whether provided in the home, office, hospital, clinic or any other suitable place either inside or outside the State of West Virginia provided or prescribed by any health care provider or providers. Such services include, among others, medical supplies, appliances, laboratory, preventive diagnostic, therapeutic and rehabilitative services, hospital care, nursing home and convalescent care, medical physicians, osteopathic physicians, chiropractors, and such other surgical including inpatient oral surgery, nursing, and podiatric services and supplies as may be prescribed by such health care providers but not other dental services.2.6. The term "health care provider" means a person, partnership, corporation, facility or institution licensed, certified or authorized by law to provide professional health care services in or outside this state to an individual during this individual's medical care, treatment or confinement. For the sole purpose of this rule and the implementation of the Act, the term does not include pharmacists and pharmacies.2.7. The term "life-threatening medical or surgical emergency" includes an emergency posing an imminent threat of significant, permanent and clearly recognizable bodily impairment such as blindness or loss of limb.2.8. The term "this rule" means the present legislative rule which has been designated as Title 69, Series 2.2.9. The term "the Secretary" means the Secretary of the Department of Health and Human Resources.