26 Tex. Admin. Code § 364.3 - Definitions
The following words and terms, when used in this subchapter shall have the following meanings, unless the context clearly indicates otherwise.
(1) Act--The Texas Primary
Health Care Services Act, Health and Safety Code, Chapter 31.
(2) Applicant--An individual and/or family
applying to receive primary health care services.
(3) Commission--The Texas Health and Human
Services Commission.
(4)
Commissioner--The Commissioner of Health.
(5) Department--The Department of State
Health Services.
(6) Eligible
individual--An eligible recipient of primary health care services under the
Act.
(7) Other benefit--A benefit,
other than a benefit provided under the Act, to which an individual is entitled
for payment of the costs of primary health care services, including:
(A) benefits available from:
(i) an insurance policy, group health plan,
or prepaid medical care plan;
(ii)
Title XVIII or Title XIX of the Social Security Act;
(iii) the Veterans Administration;
(iv) the Civilian Health and Medical Program
of the Uniformed Services; and
(v)
workers compensation or any other compulsory employer's insurance
program.
(B) a public
program created by federal or state law, or by an ordinance or rule of a
municipality or political subdivision of the state, except those benefits
created by the establishment of a city or county hospital, a joint city-county
hospital, a county hospital authority, a hospital district, or by the
facilities of a publicly supported medical school; or
(C) benefits resulting from a cause of action
for medical, facility, or medical transportation expenses, or a settlement or
judgment based on the cause of action, if the expenses are related to the need
for services provided by the Act.
(8) Primary Health Care Services--May include
the following:
(A) diagnosis and
treatment;
(B) emergency medical
services;
(C) family planning
services;
(D) preventive health
services;
(E) health
education;
(F) laboratory, x-ray,
nuclear medicine, or other appropriate diagnostic services;
(G) nutrition services;
(H) health screening;
(I) home health care;
(J) dental care;
(K) transportation;
(L) prescription drugs and devices and
durable supplies;
(M) environmental
health services;
(N) podiatry
services; and
(O) social
services.
(9)
Program--The primary health care services program created by the Act.
(10) Provider--An entity that, through a
grant or a contract with the department, delivers primary health care services
that are purchased by the department for the purposes of the Act.
(11) Recipient--An individual receiving
primary health care services under the Act.
(12) Request for proposal--A solicitation
providing guidance and instructions issued by the department to entities
interested in submitting applications to provide primary health care services
under the Act.
(13)
Services--Primary health care services.
(14) Texas resident--An individual who is
physically present within the geographic boundaries of the state, and who:
(A) intends to remain within the state,
whether permanently or for an indefinite period;
(B) does not claim residency in any other
state or country;
(C) is under 18
years of age, and at least one of his/her parents, managing conservator, or
guardian is a bona fide resident of Texas;
(D) is a person residing in Texas and his/her
legally dependent spouse is a bona fide resident of Texas; or
(E) is an adult residing in Texas whose legal
guardian is a bona fide resident of Texas.
Notes
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