56-252. DEFINITIONS. As used in sections 56-250 through 56-255, Idaho Code:

(1) "Benchmark plan" means a package of health benefits coverage that provides coverage for a specified population in accordance with section 6044 of the deficit reduction act of 2005.

(2) "Benefit design" means selection of services, providers and beneficiary cost-sharing to create the scope of coverage for participants.

(3) "Community supports" means services that promote the ability of persons with disabilities to be self-sufficient and live independently in their own communities.

(4) "Cost-sharing" means participant payment for a portion of medicaid service costs such as deductibles, coinsurance or copayment amounts.

(5) "Department" means the department of health and welfare.

(6) "Director" means the director of the department of health and welfare.

(7) "Health risk assessment" means a process of assessing the health status and health needs of participants.

(8) "Medicaid" means Idaho’s medical assistance program.

(9) "Medical assistance" means payments for part or all of the cost of services funded by titles XIX or XXI of the federal social security act as amended, as may be designated by department rule.

(10) "Medical home" means a primary care case manager designated by the participant or the department to coordinate the participant’s care.

(11) "Network management" means establishment and management of contracts between the department and limited groups of providers or suppliers of medical and other services to participants.

(12) "Participant" means a person eligible for and enrolled in the Idaho medical assistance program.

(13) "Premium assistance" means use of medicaid funds to pay part or all of the costs of enrolling eligible individuals into private insurance coverage.

(14) "Primary care case manager" means a primary care physician who contracts with medicaid to coordinate the care of certain participants.

(15) "Provider" means any individual, partnership, association, corporation or organization, public or private, which provides residential or assisted living services, certified family home services, nursing facility services or services offered pursuant to medical assistance.

(16) "Self-determination" means medicaid services that allow persons with disabilities to exercise choice and control over the services and supports they receive.

(17) "State plan" means the contract between the state and federal government under 42 U.S.C. section 1396a(a).

History:

[56-252, added 2006, ch. 278, sec. 1, p. 854; am. 2007, ch. 200, sec. 2, p. 611.]