House Bill 700 [continued]
1 "Behavioral health services." Mental health or substance
2 abuse services.
3 "Birth center." An entity licensed as a birth center under
4 the act of July 19, 1979 (P.L.130, No.48), known as the Health
5 Care Facilities Act.
6 "CAP" or "Cover All Pennsylvanians." The health insurance
7 program established under section 7202 (relating to Cover All
8 Pennsylvanians health insurance program).
9 "CAP Fund." The restricted account established under section
10 7202 (relating to Cover All Pennsylvanians health insurance
11 program).
12 "Children's Health Care Program" or "CHIP." The Children's
13 Health Care Program established under Article XXIII of the act
14 of May 17, 1921 (P.L.682, No.284), known as The Insurance
15 Company Law of 1921.
16 "Commonwealth Attorneys Act." The act of October 15, 1980
17 (P.L.950, No.164), known as the Commonwealth Attorneys Act.
18 "Commonwealth Documents Law." The act of July 31, 1968
19 (P.L.769, No.240), referred to as the Commonwealth Documents
20 Law.
21 "Council." The Health Care Cost Containment Council
22 established under the act of July 8, 1986 (P.L.408, No.89),
23 known as the Health Care Cost Containment Act.
24 "Employer." The term shall include:
25 (1) Any of the following who or which employ one or more
26 employees to perform services for remuneration for any period
27 of time:
28 (i) An individual, copartnership, association,
29 domestic or foreign corporation or other entity.
30 (ii) The legal representative, trustee in
20070H0700B1011 - 6 -
--------------------------------------------------------------------------------
1 bankruptcy, receiver or trustee of any individual,
2 copartnership, association or corporation or other
3 entity.
4 (iii) The legal representative of a deceased
5 individual.
6 (2) Individuals who are self-employed.
7 (3) The executive, legislative and judicial branches of
8 the Commonwealth and any of its political subdivisions.
9 "Fiscal year." A period of 12 consecutive calendar months
10 commencing with July 1.
11 "Health Care Cost Containment Act." The act of July 8, 1986
12 (P.L.408, No.89), known as the Health Care Cost Containment Act.
13 "Health Care Facilities Act." The act of July 19, 1979
14 (P.L.130, No.48), known as the Health Care Facilities Act.
15 "Health care facility." An ambulatory surgical facility,
16 birth center, hospital or nursing home.
17 "Health care provider." Any of the following:
18 (1) A licensee.
19 (2) A health care facility.
20 (3) An officer, employee or agent of any of the entities
21 under paragraph (1) or (2) acting in the course and scope of
22 employment.
23 "Hospital." An entity licensed as an acute-care general
24 hospital, a specialty hospital or rehabilitation hospital under
25 the act of July 19, 1979 (P.L.130, No.48), known as the Health
26 Care Facilities Act.
27 "Institutions of Purely Public Charity Act." The act of
28 November 26, 1997 (P.L.508, No.55), known as the Institutions of
29 Purely Public Charity Act.
30 "Insurer." A company or health insurance entity licensed in
20070H0700B1011 - 7 -
--------------------------------------------------------------------------------
1 this Commonwealth to issue any individual or group health,
2 sickness or accident policy or subscriber contract or
3 certificate or plan that provides medical or health care
4 coverage by a health care facility or licensed health care
5 provider that is offered or governed under the act of May 17,
6 1921 (P.L.682, No.284), known as The Insurance Company Law of
7 1921, or any of the following:
8 (1) The act of December 29, 1972 (P.L.1701, No.364),
9 known as the Health Maintenance Organization Act.
10 (2) The act of May 18, 1976 (P.L.123, No.54), known as
11 the Individual Accident and Sickness Insurance Minimum
12 Standards Act.
13 (3) Chapter 61 (relating to hospital plan corporations)
14 or 63 (relating to professional health services plan
15 corporations).
16 (4) Section 630 of The Insurance Company Law of 1921.
17 (5) Sections 2401 through 2466 of The Insurance Company
18 Law of 1921.
19 "Licensee." An individual who is licensed by the Department
20 of State to provide professional health care services in this
21 Commonwealth.
22 "Mcare." The act of March 20, 2002 (P.L.154, No.13), known
23 as the Medical Care Availability and Reduction of Error (Mcare)
24 Act.
25 "Medical assistance." The program of medical assistance
26 established under the act of June 13, 1967 (P.L.31, No.21),
27 known as the Public Welfare Code.
28 "Medicare." The Federal program established under Title
29 XVIII of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1395
30 et seq.).
20070H0700B1011 - 8 -
--------------------------------------------------------------------------------
1 "Nursing home." An entity licensed as a long-term care
2 nursing facility under the act of July 19, 1979 (P.L.130,
3 No.48), known as the Health Care Facilities Act.
4 "PACE." The Pharmaceutical Assistance Contract for the
5 Elderly established under the act of August 26, 1971 (P.L.351,
6 No.91), known as the State Lottery Law.
7 "Prevailing Wage Act." The act of August 15, 1961 (P.L.987,
8 No.442), known as the Pennsylvania Prevailing Wage Act.
9 "Public Welfare Code." The act of June 13, 1967 (P.L.31,
10 No.21), known as the Public Welfare Code.
11 "Regulatory Review Act." The act of June 25, 1982 (P.L.633,
12 No.181), known as the Regulatory Review Act.
13 "Tax Reform Code." The act of March 4, 1971 (P.L.6, No.2),
14 known as the Tax Reform Code of 1971.
15 "Tobacco Settlement Act." The act of June 26, 2001 (P.L.755,
16 No.77), known as the Tobacco Settlement Act.
17 "Unemployment Compensation Law." The act of December 5, 1936
18 (2nd Sp.Sess., 1936 P.L.2897, No.1), known as the Unemployment
19 Compensation Law.
20 CHAPTER 72
21 AFFORDABILITY
22 Sec.
23 7201. Definitions.
24 7202. Cover All Pennsylvanians health insurance program.
25 7203. Fair share tax.
26 7204. Health insurance rate increases and standard plans.
27 7205. Health insurance coverage for full-time students.
28 7206. Health insurance coverage for certain children of insured
29 parents.
30 7207. Hospital community benefit requirements.
20070H0700B1011 - 9 -
--------------------------------------------------------------------------------
1 7208. Uniform admission and fair billing and collection
2 practices.
3 7209. Transparency in price and quality for consumers.
4 § 7201. Definitions.
5 The following words and phrases, when used in this chapter,
6 shall have the meanings given to them in this section unless the
7 context clearly indicates otherwise:
8 "AdultBasic." The health investment insurance program
9 established under Chapter 13 of the Tobacco Settlement Act.
10 "Average annual wage." The total annual wages paid by an
11 employer divided by the number of the employer's employees.
12 "Basic benefit package." The minimum health benefit
13 insurance plan determined by the Insurance Commissioner under
14 section 7202 (relating to Cover All Pennsylvanians health
15 insurance program).
16 "CAP contracts." The contracts entered into under section
17 7202 (relating to Cover All Pennsylvanians health insurance
18 program).
19 "Charitable institution." A hospital that possesses an
20 exemption from tax under Article II of the Tax Reform Code
21 because it meets the criteria for being an institution of purely
22 public charity as set forth in section 5 of the Institutions of
23 Purely Public Charity Act.
24 "Chronic care model." A model based on the redesign of
25 health care delivery so that patients, who are supported by a
26 health care team, play an active role in their care and so that
27 there is an infrastructure to ensure compliance with established
28 practice guidelines. The model includes the following six
29 components:
30 (1) Providing patients with chronic conditions support
20070H0700B1011 - 10 -
| © 2008 Philadelphia Unemployment Project | site design KC Ellis |