Utah Administrative Code
Topic - Health
Title R382 - Children's Health Insurance Program
Rule R382-3 - Managed Care Organization Incentives to Appropriately Use Emergency Room Services in the Children's Health Insurance Program
Section R382-3-2 - Definitions

Universal Citation: UT Admin Code R 382-3-2

Current through Bulletin 2024-06, March 15, 2024

(1) "CHIP Beneficiary" means a child under 19 years of age who is determined eligible for the Children's Health Insurance Program under Title XXI of the Social Security Act as adopted in the state under Title 26, Chapter 40, Utah Children's Health Insurance Act.

(2) "Non-emergent medical condition" means a medical condition that does not meet the criteria of an emergency medical condition under 42 U.S.C. 1395dd(e) of the Emergency Medical Treatment and Active Labor Act.

(3) "Non-emergent medical care" means medical care provided in an emergency room for the treatment of a non-emergent medical condition.

(4) "Non-emergent medical care" does not mean:

(a) medical services necessary to conduct a medical screening examination to determine if the CHIP beneficiary has an emergent or non-emergent medical condition; nor

(b) medical care provided to a CHIP beneficiary who is experiencing an "emergency medical condition" as defined by 42 U.S.C. 1395dd(e) of the Emergency Medical Treatment and Active Labor Act.

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