Sec. 30711. Definitions

845 words·~4 min read·/bill/117/hr/5376/rh/section-30711·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

In this part: The term appropriate committees of Congress means the Committee on Energy and Commerce of the House of Representatives, the Committee on Finance of the Senate, the Committee on Health, Education, Labor and Pensions of the Senate, and the Special Committee on Aging of the Senate. The term direct care worker means, with respect to a State, any of the following individuals who by contract, by receipt of payment for care, or as a result of the operation of law, provides directly to Medicaid eligible individuals home and community-based services available under the State Medicaid program:

A registered nurse, licensed practical nurse, nurse practitioner, or clinical nurse specialist who provides licensed nursing services, or a licensed nursing assistant who provides such services under the supervision of a registered nurse, licensed practical nurse, nurse practitioner, or clinical nurse specialist. A direct support professional. A personal care attendant. A home health aide. Any other paid health care professional or worker determined to be appropriate by the State and approved by the Secretary.

The term HCBS program improvement State means a State that is awarded a planning grant under section 1011(a) and has an HCBS improvement plan approved by the Secretary under section 1011(d). The term health plan means any of the following entities that provide or arrange for home and community-based services for Medicaid eligible individuals who are enrolled with the entities under a contract with a State: A medicaid managed care organization, as defined in section 1903(m)(1)(A) of the Social Security Act ( 42 U.S.C. 1396b(m)(1)(A) ).

A prepaid inpatient health plan or prepaid ambulatory health plan, as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)). Any other entity determined to be appropriate by the State and approved by the Secretary. The term home and community-based services means any of the following (whether provided on a fee-for-service, risk, or other basis): Home health care services authorized under paragraph

(7)of section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) ). Private duty nursing services authorized under paragraph

(8)of such section, when such services are provided in a Medicaid eligible individual’s home. Personal care services authorized under paragraph

(24)of such section. PACE services authorized under paragraph

(26)of such section. Home and community-based services authorized under subsections (b), (c), (i), (j), and

(k)of section 1915 of such Act ( 42 U.S.C. 1396n ), authorized under a waiver under section 1115 of such Act ( 42 U.S.C. 1315 ), or provided through coverage authorized under section 1937 of such Act ( 42 U.S.C. 1396u–7 ). Case management services authorized under section 1905(a)(19) of the Social Security Act ( 42 U.S.C. 1396d(a)(19) ) and section 1915(g) of such Act ( 42 U.S.C. 1396n(g) ). Rehabilitative services, including those related to behavioral health, described in section 1905(a)(13) of such Act ( 42 U.S.C. 1396d(a)(13) ). Self-directed personal assistance services authorized under section 1915(j) of the Social Security Act ( 42 U.S.C. 1396n(j) ). School-based services when the school is the location for provision of services if the services are— authorized under section 1905(a) of such Act ( 42 U.S.C. 1396d(a) ) (or under a waiver under section 1915(c) or demonstration under section 1115) ; and described in another subparagraph of this paragraph. Such other services specified by the Secretary. The term institutional setting means— a skilled nursing facility (as defined in section 1819(a) of the Social Security Act ( 42 U.S.C. 1395i–3(a) )); a nursing facility (as defined in section 1919(a) of such Act ( 42 U.S.C. 1396r(a) )); a long-term care hospital (as described in section 1886(d)(1)(B)(iv) of such Act ( 42 U.S.C. 1395ww(d)(1)(B)(iv) )); a facility (or distinct part thereof) described in section 1905(d) of such Act ( 42 U.S.C. 1396d(d) )); an institution (or distinct part thereof) which is a psychiatric hospital (as defined in section 1861(f) of such Act ( 42 U.S.C. 1395x(f) )) or that provides inpatient psychiatric services in a residential setting specified by the Secretary; an institution (or distinct part thereof) described in section 1905(i) of such Act ( 42 U.S.C. 1396d(i) ); and any other relevant facility, as determined by the Secretary. The term Medicaid eligible individual means an individual who is eligible for and receiving medical assistance under a State Medicaid plan or a waiver such plan. Such term includes an individual who would become eligible for medical assistance and enrolled under a State Medicaid plan, or waiver of such plan, upon removal from a waiting list. The term State Medicaid program means, with respect to a State, the State program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (including any waiver or demonstration under such title or under section 1115 of such Act ( 42 U.S.C. 1315 ) relating to such title). The term Secretary means the Secretary of Health and Human Services. The term State means each of the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.

Connectionstraces to 8

Traces to 8 documents

U.S. Code