Sec. 1101. Definitions
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/bill/116/hr/1384/ih/section-1101·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
In this Act— the term group practice has the meaning given such term in section 1877(h)(4) of the Social Security Act ( 42 U.S.C. 1395nn(h)(4) ); the term individual provider means a supplier (as defined for purposes of paragraph (4)); the term institutional provider means— providers of services described in section 1861(u) of such Act ( 42 U.S.C. 1395x(u) ); hospitals as defined in section 1861(e) of the Social Security Act ( 42 U.S.C. 1395x(e) ), and any outpatient settings or clinics operating within a hospital license or any setting or clinic that provides outpatient hospital services; psychiatric hospitals (as defined in section 1861(e) of the Social Security Act ( 42 U.S.C. 1395x(f) )); rehabilitation hospitals (as defined by the Secretary of Health and Human Services under section 1886(d)(1)(B)(ii) of the Social Security Act ( 42 U.S.C. 1395ww(d)(1)(B)(ii) )); long-term care hospitals as defined in section 1861 of the Social Security Act ( 42 U.S.C. 1395x(ccc) ); and independent dialysis facilities and independent end-stage renal disease facilities as described in 42 CFR 413.174(b); the term medically necessary or appropriate means the health care items and services or supplies are needed or appropriate to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms for an individual and are determined to be necessary or appropriate for such individual by the physician or other health care professional treating such individual, after such professional performs an assessment of such individual’s condition, in a manner that meets— the scope of practice, licensing, and other law of the State in which such items and services are to be furnished; and appropriate standards established by the Secretary for purposes of carrying out this Act; the term provider means an institutional provider or a supplier (as defined in section 1861(d) of such Act ( 42 U.S.C. 1395x(d) ) if the reference to this title were a reference to the Medicare for All Program); the term Secretary means the Secretary of Health and Human Services; the term State means a State, the District of Columbia, or a territory of the United States; and the term United States shall include the States, the District of Columbia, and the territories of the United States.
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- 42 CFR 413.174(b)
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