Section 25.5-3-301 - [Effective until 7/1/2025] DefinitionsAs used in this part 3, unless the context otherwise requires:
(1) "Comprehensive primary care" means the basic, entry-level health care provided by health-care practitioners or non-physician health-care practitioners that is generally provided in an outpatient setting. "Comprehensive primary care", at a minimum, includes providing or arranging for the provision of the following services on a year-round basis: Primary health care; maternity care, including prenatal care; preventive, developmental, and diagnostic services for infants and children; adult preventive services; diagnostic laboratory and radiology services; emergency care for minor trauma; pharmaceutical services; and coordination and follow-up for hospital care. "Comprehensive primary care" may also include optional services based on a patient's needs. For the purposes of this subsection (1) and subsection (2) of this section, "arranging for the provision" means demonstrating established referral relationships with health-care providers for any of the comprehensive primary care services not directly provided by an entity. An entity in a rural area may be exempt from this requirement if it can demonstrate that there are no providers in the community to provide one or more of the comprehensive primary care services.(2) "Qualified provider" means an entity that provides comprehensive primary care services and that: (a) Accepts all patients regardless of their ability to pay and uses a sliding fee schedule for payments or that provides comprehensive primary care services free of charge;(b) Serves a designated medically underserved area or population, as provided in section 330(b) of the federal "Public Health Service Act", 42 U.S.C. sec. 254b, or demonstrates to the state department that the entity serves a population or area that lacks adequate health-care services for low-income, uninsured persons;(c) Has a demonstrated track record of providing cost-effective care;(d) Provides or arranges for the provision of comprehensive primary care services to persons of all ages; and(e) Completes initial screening for eligibility for the state medical assistance program, the children's basic health plan, and any other relevant government health-care program and referral to the appropriate agency for eligibility determination.(3) "Uninsured or medically indigent patient" means a patient receiving services from a qualified provider:(a) Whose yearly family income is below two hundred percent of the federal poverty line; and(b) Who is not eligible for medicaid, medicare, or any other type of governmental reimbursement for health-care costs; and(c) Who is not receiving third-party payments.L. 2012: Entire part RC&RE, (HB 12-1203), ch. 5, p. 15, § 1, effective March 1.This section is set out more than once due to postponed, multiple, or conflicting amendments.