205.510 Definitions for medical assistance law.
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/ky/chapter-205/205-510A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
As used in this chapter as it pertains to medical assistance unless the context clearly requires a different meaning:
(1)"Behavioral health professional" means a person authorized to provide mental
health or substance use disorder services under the laws of the Commonwealth;
(2)"Chiropractor" means a person authorized to practice chiropractic under the laws of
the Commonwealth;
(3)"Council" means the Advisory Council for Medical Assistance;
(4)"Dentist" means a person authorized to practice dentistry under laws of the
Commonwealth;
(5)"Health professional" means a physician, physician assistant, nurse, doctor of
chiropractic, behavioral health professional, optometrist, dentist, or allied health
professional who is licensed in Kentucky;
(6)"Medical care" as used in this chapter means essential medical, surgical,
chiropractic, dental, optometric, podiatric, telehealth, and nursing services, in the
home, office, clinic, or other suitable places, which are provided or prescribed by
physicians, optometrists, podiatrists, or dentists licensed to render such services,
including drugs and medical supplies, appliances, laboratory, diagnostic and
therapeutic services, nursing-home and convalescent care, hospital care as defined
in KRS 205.560(1)(a), and such other essential medical services and supplies as
may be prescribed by such persons; but not including abortions, or induced
miscarriages or premature births, unless in the opinion of a physician such
procedures are necessary for the preservation of the life of the woman seeking such
treatment or except in induced premature birth intended to produce a live viable
child and such procedure is necessary for the health of the mother or her unborn
child. However, this section does not authorize optometrists to perform any services
other than those authorized by KRS Chapter 320;
(7)"Nurse" means a person authorized to practice professional nursing under the laws
of the Commonwealth;
(8)"Nursing home" means a facility which provides routine medical care in which
physicians regularly visit patients, which provide nursing services and procedures
employed in caring for the sick which require training, judgment, technical
knowledge, and skills beyond that which the untrained person possesses, and which
maintains complete records on patient care, and which is licensed pursuant to the
provisions of KRS 216B.015;
(9)"Optometrist" means a person authorized to practice optometry under the laws of
the Commonwealth;
(10)"Other persons eligible for medical assistance" may include the categorically needy
excluded from monetary payment status by state requirements and classifications of
medically needy individuals as permitted by federal laws and regulations and as
prescribed by administrative regulation of the secretary for health and family
services or his designee;
(11)"Pharmacist" means a person authorized to practice pharmacy under the laws of the
Commonwealth;
(12)"Physician" means a person authorized to practice medicine or osteopathy under the
laws of the Commonwealth;
(13)"Podiatrist" means a person authorized to practice podiatry under the laws of the
Commonwealth;
(14)"Primary-care center" means a facility which provides comprehensive medical care
with emphasis on the prevention of disease and the maintenance of the patients'
health as opposed to the treatment of disease;
(15)"Public assistance recipient" means a person who has been certified by the
Department for Community Based Services of the Cabinet for Health and Family
Services as being eligible for, and a recipient of, public assistance under the
provisions of this chapter;
(16)"Telehealth" means the same as in KRS 211.332;
(17)"Telehealth consultation" means a medical or health consultation, for purposes of
patient diagnosis or treatment, that meets the definition of telehealth in this section;
(18)"Third party" means an individual, institution, corporation, company, insurance
company, personal representative, administrator, executor, trustee, or public or
private agency, including, but not limited to, a reparation obligor and the assigned
claims bureau under the Motor Vehicle Reparations Act, Subtitle 39 of KRS
Chapter 304, who is or may be liable to pay all or part of the medical cost of injury,
disease, or disability of an applicant or recipient of medical assistance provided
under Title XIX of the Social Security Act, 42 U.S.C. sec. 1396 et seq.; and
(19)"Vendor payment" means a payment for medical care which is paid by the Cabinet
for Health and Family Services directly to the authorized person or institution which
rendered medical care to an eligible recipient.