Section 50-24.8-01 - DefinitionsAs used in this chapter, unless the context otherwise requires:
1. "Benefit" means the provision of anything of pecuniary value under the Medicaid program.2. "Claim" means: a. Any request or demand, whether under a contract or otherwise, for money or property under the Medicaid program regardless of whether the state has title to the money or property which is: (1) Presented to an officer, employee, or agent of the state; or(2) Made to a contractor, grantee, or other recipient, if the money or property is to be spent or used on the state's behalf or to advance a state program or interest, and if the state:(a) Provides or has provided any portion of the money or property requested or demanded; or(b) Will reimburse such contractor, grantee, or other recipient for any portion of the money or property that is requested or demanded.b. A claim does not include requests or demands for money or property the state has paid to an individual as compensation for state employment or as an income subsidy with no restrictions on that individual's use of the money or property.3. "Department" means the department of health and human services.4. "Document" means an application, claim, form, report, record, writing, or correspondence, whether in written, electronic, magnetic, or other form.5. "Fraud" means any conduct or activity prohibited by law or rule involving knowing conduct or omission to perform a duty that results in or may result in payments to which the person is not entitled.6. "Knowingly" means "knowingly" as defined in section 12.1-02-02.7. "Material" means having a natural tendency to influence, or be capable of influencing, the payment or receipt of money or property.8. "Medicaid agency" means an agency or entity of state, county, or local government which administers any part of the Medicaid program, whether under direct statutory authority or under contract with an authorized agency of the state or federal government.9. "Misappropriation of patient property" means exploitation, deliberate misplacement, or wrongful use or taking of a patient's property, whether temporary or permanent, without authorization by the patient or the patient's designated representative. The term includes conduct with respect to a patient's property, which would constitute a criminal offense under chapter 12.1-23.10. "Obligation" means an established duty, whether fixed, arising from an express or implied contractual, grantor-grantee, or licensor-licensee relationship, from a fee-based or similar relationship, from statute or regulation, or from the retention of any overpayment.11. "Patient abuse" means the willful infliction of physical or mental injury of a patient or unreasonable confinement, intimidation, or punishment that results in pain, physical or mental harm, or mental anguish of a patient. The term includes conduct with respect to a patient which would constitute a criminal offense under chapter 12.1-16, 12.1-17, 12.1-18, 12.1-20, or 12.1-22.12. "Patient neglect" means a failure, through inattentiveness, carelessness, or other omission, to provide to a patient goods and services necessary to avoid physical harm, mental anguish, or mental illness if an omission is not caused by factors beyond the person's control or by good-faith errors in judgment. The term includes conduct with respect to a patient which would constitute a criminal offense under section 12.1-17-03.13. "Provider" means a person that furnishes items or services for which payment is claimed under the Medicaid program.14. "Record" means medical, professional, business, or financial information and documents, whether in written, electronic, magnetic, microfilm, or other form: a. Pertaining to the provision of treatment, care, services, or items to a recipient;b. Pertaining to the income and expenses of the provider; orc. Otherwise relating to or pertaining to a determination of entitlement to payment or reimbursement under the Medicaid program.Amended by S.L. 2021 , ch. 352( HB 1247 ), § 466, eff. 9/1/2022.Added by S.L. 2019 , ch. 415( SB 2347 ), § 1, eff. 8/1/2019.