Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 357 - HEARINGS
Subchapter P - CIVIL MONETARY PENALTIES
Section 357.641 - Definitions
Current through Reg. 49, No. 38; September 20, 2024
The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
(1) Claim--An application for payment of health care services under Title XIX of the Social Security Act that is submitted by a person who is under a contract or provider agreement with DHS.
(2) Contract or provider agreement--Any written document (or series of documents) that obligates DHS or its health insuring agent to pay a person money under Title XIX of the Social Security Act in exchange for his goods or services. Included are claims for payment that a licensed practitioner (as defined by federal law) submits for services provided to Medicaid recipients.
(3) Commissioner--The commissioner of the Texas Department of Human Services.
(4) Days--Calendar days, unless otherwise specified.
(5) Department--The Texas Department of Human Services.
(6) Health insuring agent--An organization legally operating in the state that:
(7) Person--An individual, partnership, corporation, association, other organization, or legal entity that has a contract or provider agreement with DHS.
(8) Practitioner--A physician or other person licensed by the state to practice a profession.
(9) Provider--A person who has a contract or provider agreement with DHS.
(10) Title XIX--Title XIX of the Social Security Act.
