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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 29. PUBLIC WELFARE |
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Chapter 29-89. MEDICAID ELECTRONIC HEALTH RECORD INCENTIVE PAYMENT PROGRAM (MEIP) |
Section 29-8999. DEFINITIONS
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Acute care hospital: A health care facility: (1) where the average length of patient stay is twenty-five (25) days or fewer; and (2) with a Centers for Medicare and Medicaid Services (CMS) certification number (previously known as the Medicare provider number) that has the last four (4) digits in the series 0001–0879 or 1300–1399 pursuant to 42 C.F.R. § 495.302.
Children’s hospital:A separately certified children's hospital, either freestanding or hospital-within-hospital that (1) has a CMS certification number (CCN), (previously known as the Medicare provider number), that has the last four (4) digits in the series 3300–3399; or (2) does not have a CCN but has been provided an alternative number by CMS for purposes of enrollment in MEIP as a children's hospital; and; (3) predominantly treats individuals under twenty-one (21) years of age, pursuant to 42 C.F.R. § 495.302.
Hospital based professional: As defined in 42 C.F.R. § 495.4, a professional who furnishes ninety (90) percent or more of covered professional services in sites of service identified by the codes used in the Health Insurance Portability and Accountability Act of 1996, enacted August 21, 1996 (Pub.L. 104–191, 110 Stat. 1936) (HIPAA) standard transaction as an inpatient hospital or emergency room setting in the year preceding the payment year, or in the case of a payment adjustment year, in either of the two (2) years before such payment adjustment year.
Federally Qualified Health Center (FQHC): An entity that meets the definition set forth in § 1905(l)(2)(B) of the Social Security Act (42 U.S.C. § 1396d(l)(2)(B)).
Medicaid encounter: Services rendered in accordance with 42 C.F.R. § 495.306(e).
Needy individuals: As defined at 42 C.F.R. § 495.302, individuals who: received medical assistance from Medicaid or the Children's Health Insurance Program (or a Medicaid or CHIP demonstration project approved under § 1115 of the Social Security Act); were furnished uncompensated care by the provider; or were furnished services at either no cost or reduced cost based on a sliding scale determined by the individuals' ability to pay.
Patient Encounter: Services rendered to an individual pursuant to 42 C.F.R. § 495.306(e).
Patient Volume: The minimum participation threshold pursuant to 42 C.F.R. § 495.304(c)-(e), § 495.306, and the District of Columbia State Medicaid Health Information Technology Plan.
Payment year: For an eligible professional, a calendar year (CY) beginning with CY 2011 and for an eligible hospital, a federal fiscal year (FFY) beginning with FFY 2011.
Provider: For the purposes of this section, the term “provider” shall include both health care professionals and hospitals.