Section 102. Definitions.
The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise:
"Chronic care and disease management." A model of care that includes the following:
(1) The provision of effective health management through support and information that also promotes patient self-care for patients with chronic conditions.
(2) The use of evidence-based medicine to ensure appropriate treatment decisions by health care providers.
(3) The coordination of care and use of reasonably accessible and updated patient information that encourages follow-up care as a standard procedure.
(4) The tracking of clinical information for individual and general patient populations to guide treatment and effectively anticipate community health care problems.
"Community-based health care clinic." A nonprofit health care center located in this Commonwealth that provides comprehensive health care services without regard for a patient's ability to pay and that:
(1) meets either of the following criteria:
(i) serves a federally designated medically underserved area, a medically underserved population or a health professional shortage area; or
(ii) serves a patient population with a majority of that population having an income less than 200% of the Federal poverty income guidelines; and
(2) includes any of the following:
(i) A federally qualified health center as defined in section 1905(l)(2)(B) of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1396d(l)(2)(B)) or a federally qualified health center look-alike and is a participating provider with:
(A) the Department of Public Welfare under the act of June 13, 1967 (P.L.31, No.21), known as the Public Welfare Code; or
(B) the Children's Health Insurance Program under:
(I) Title XXI of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1397aa et seq.); and
(II) Article XXIII of the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, and the regulations promulgated thereunder.
(ii) A rural health clinic as defined in section 1861(aa)(2) of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1395x(aa)(2)), certified by Medicare and is a participating provider with:
(A) the Department of Public Welfare under the Public Welfare Code; or
(B) the Children's Health Insurance Program under:
(I) Title XXI of the Social Security Act; and
(II) Article XXIII of The Insurance Company Law of 1921 and the regulations promulgated thereunder.
(iii) A hospital health clinic and is a participating provider with:
(A) the Department of Public Welfare under the Public Welfare Code; or
(B) the Children's Health Insurance Program under:
(I) Title XXI of the Social Security Act; and
(II) Article XXIII of The Insurance Company Law of 1921 and the regulations promulgated thereunder.
(iv) A free or partial-pay health clinic that provides services by volunteer and nonvolunteer health care providers.
(v) A nurse-managed health care clinic that is managed by a certified clinical nurse specialist, a certified registered nurse anesthetist, a certified registered nurse practitioner or a certified nurse midwife, is associated with a nursing education program, a federally qualified health center or an independent nonprofit health or social services agency and is a participating provider with:
(A) the Department of Public Welfare under the Public Welfare Code; or
(B) the Children's Health Insurance Program under:
(I) Title XXI of the Social Security Act; and
(II) Article XXIII of The Insurance Company Law of 1921 and the regulations promulgated thereunder.
"Department." The Department of Health of the Commonwealth.
"Health care provider." A health care provider licensed to practice a component of the healing arts by a licensing board within the Department of State who provides health care services at a community-based health care clinic.
"Hospital." An entity located in this Commonwealth that is licensed as a hospital under the act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act.
"Low-income patient." A patient whose household income is below 200% of the Federal poverty income guidelines.
"Medical assistance." A State program of medical assistance established under Article IV(f) of the act of June 13, 1967 (P.L.31, No.21), known as the Public Welfare Code.
"Patient." A natural person receiving health care from a health care provider at a community-based health care clinic.
"Program." The Community-Based Health Care Program.
Compiler's Note: The short title of the act of June 13, 1967 (P.L.31, No.21), known as the Public Welfare Code, referred to in this section, was amended by the act of December 28, 2015 (P.L.500, No.92). The amended short title is now the Human Services Code.
Compiler's Note: The Department of Public Welfare, referred to in this section, was redesignated as the Department of Human Services by Act 132 of 2014.