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<regulation prefix="Regulation" num=".01" citation="COMAR 10.09.57.01" title_num="10" subtitle_num="09" chapter_num="57" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Applicant” means an entity which submits an application to become a partially capitated provider.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Capitation payment” means the sum of money paid by the Program on behalf of an enrollee on a regular periodic per capita basis for capitated services.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Capitated services” means a service provided by a PCP or one of its subcontractors for which the Department has agreed to pay a capitation payment to the PCP.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Department” means the Maryland Department of Health, the single State agency designated to administer the Maryland Medical Assistance Program under Title XIX of the Social Security Act, 42 U.S.C. §1396 et seq.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Enrollee” means a recipient who has entered into an agreement to receive certain Medical Assistance services from or through a PCP.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Medical Assistance Program” has the meaning stated in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Partially capitated provider (PCP)” means a public or private legal entity which is organized for the purpose of providing or arranging for the provision of medical and health-related services which meets the conditions for participation in Regulations .02 and .03 of this chapter for enrollment and which is eligible to enter into a contract with the Department to receive a capitated payment for a limited number of services.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Program” means the Maryland Medical Assistance Program as defined in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Provider” means a partially capitated provider.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Provider agreement” means the agreement between the Department and the partially capitated provider which specifies the terms of the relationship between the Department and the provider, and includes the amount of the capitation payment and the specific services to be provided for the capitation payment.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Recipient” has the meaning stated in COMAR 10.09.36.01.</text>
    </paragraph>
  </paragraph>
</regulation>