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<regulation prefix="Regulation" num=".02" citation="COMAR 10.14.04.02" title_num="10" subtitle_num="14" chapter_num="04" 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>“Annual gross income” means the total amount of income received by the applicant and, if applicable, the applicant's spouse, each year from all sources before taxes are withheld.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Applicant” means an individual who has applied to receive services under this chapter.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Biennial” means once every other year.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Breast and Cervical Cancer Program” means the program that is:</text>
      <paragraph num="(a)">
        <text>Administered by:</text>
        <paragraph num="(i)">
          <text>A local health department; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A private entity that contracts with the Department to render services in Baltimore City and Calvert County under the Breast and Cervical Cancer Program;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Established for the early detection of breast and cervical cancer; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Funded by:</text>
        <paragraph num="(i)">
          <text>The federal Centers for Disease Control and Prevention;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The Breast Cancer Program under Health-General Article, §20-116, Annotated Code of Maryland; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Both.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>“Breast Cancer Program” means the program created by Health-General Article, §20-116, Annotated Code of Maryland, to provide:</text>
      <paragraph num="(a)">
        <text>At least biennial screening mammograms and clinical breast examinations to low-income, underinsured and low-income, uninsured women 40 years old through 49 years old;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Annual screening mammograms and clinical breast examinations to low-income, underinsured and low-income, uninsured women 50 years old or older; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Diagnosis and treatment for individuals who are identified by the Breast Cancer Program as being in need.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>“Clinical breast examination” means a physical examination of the breast performed by a health care professional for the purpose of detecting breast cancer.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Contract” means the written agreement between a local health department and a health care provider for the provision of breast cancer services.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Copayment” means the set amount of money that an individual who is enrolled in a health insurance plan is responsible for paying each time the individual receives a medical service after the deductible, if applicable, has been paid.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Deductible” means a specific sum of money that an individual who is enrolled in a health insurance plan is required to pay before the individual's health insurance plan reimburses the individual or the individual's medical provider for covered medical services received.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Department” means the Maryland Department of Health.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Diagnosis” means a histopathologic finding of breast cancer in a biopsy specimen.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Eligible individual” means an applicant who meets the requirements of Regulation .03 of this chapter.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Enrollee” means an eligible individual who has been accepted into the Breast Cancer Program.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Free-standing ambulatory surgical center” means a facility that:</text>
      <paragraph num="(a)">
        <text>Provides ambulatory surgical services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Is physically separate from a hospital or hospital grounds;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Is certified by Medicare to provide ambulatory surgical services in Maryland or a jurisdiction bordering Maryland under the laws of that jurisdiction; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Complies with COMAR 10.09.42.02 and .03B.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(15)">
      <text>“Home health services provider” means a public or private agency, organization, or part of an agency or organization licensed in Maryland or a jurisdiction bordering Maryland that:</text>
      <paragraph num="(a)">
        <text>Meets one of the following licensure requirements:</text>
        <paragraph num="(i)">
          <text>If the provider is a home health agency located in Maryland, the provider is licensed under Health-General Article, Title 19, Subtitle 4, Annotated Code of Maryland;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>If the provider is a home health agency located in a jurisdiction bordering Maryland, the provider is legally authorized to provide home health services under the laws of that jurisdiction;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>If the provider is part of a hospital or related institution located in Maryland, the provider is licensed under Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland; or</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>If the provider is an individual who has a contractual agreement with the Department to provide skilled nursing care to eligible individuals, the individual is a nurse who is licensed under Health Occupations Article, Title 8, Subtitle 3, Annotated Code of Maryland, to practice registered nursing;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Provides nursing or physical therapy services in the home; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Meets the requirements for participation in Medicare.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(16)">
      <text>“Hospital” means an institution which is located:</text>
      <paragraph num="(a)">
        <text>In Maryland, that is:</text>
        <paragraph num="(i)">
          <text>Subject to the provisions of Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Licensed pursuant to COMAR 10.07.01; or</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>In a jurisdiction bordering Maryland, that is licensed pursuant to applicable standards established by the jurisdiction in which the hospital is located.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(17)">
      <text>“Local health department” means a governmental entity that provides public health services on behalf of a county in Maryland or Baltimore City.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Mammogram” means an X-ray examination of the breast to detect breast cancer that uses equipment:</text>
      <paragraph num="(a)">
        <text>Specifically dedicated for mammography, including:</text>
        <paragraph num="(i)">
          <text>X-ray tubes;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Filters;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Compression devices;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Screens;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Films; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Cassettes; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>That is designed to deliver an average radiation exposure of less than one rad mid-breast with two views for each breast.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(19)">
      <text>“Medical Assistance” means the program that:</text>
      <paragraph num="(a)">
        <text>Provides comprehensive medical and other health-related care for eligible individuals; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Is administered by the State under Title XIX of the Social Security Act, 42 U.S.C. §1396.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(20)">
      <text>“Medical laboratory” means a laboratory that:</text>
      <paragraph num="(a)">
        <text>Examines tissue specimens in connection with the diagnosis, treatment, or control of human disease or the assessment of human health or nutritional or medical conditions; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Is in compliance with the applicable license requirements for a medical laboratory providing services for Maryland residents including, but not limited to the requirements:</text>
        <paragraph num="(i)">
          <text>For Medicare certification;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Set forth in Health-General Article, Title 17, Annotated Code of Maryland;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Set forth in COMAR 10.10.01 — 10.10.08; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Of the federal Clinical Laboratories Improvement Act, 42 U.S.C. §263a.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(21)">
      <text>“Medical supply company” means a provider of disposable medical supplies or durable medical equipment that, to the extent required by law, is licensed and legally authorized to practice or deliver services in Maryland or in a jurisdiction bordering Maryland under the laws of that jurisdiction.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Medicare” means the medical insurance program administered by the federal government under Title XVIII of the Social Security Act, 42 U.S.C. §1395.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Nurse anesthetist” means a registered nurse who is:</text>
      <paragraph num="(a)">
        <text>Certified as a nurse anesthetist in Maryland or a jurisdiction bordering Maryland under the laws of that jurisdiction; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Currently collaborating with an anesthesiologist or other physician who is licensed to practice medicine:</text>
        <paragraph num="(i)">
          <text>In Maryland as prescribed by COMAR 10.27.06; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>In a jurisdiction bordering Maryland under the laws of that jurisdiction.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(24)">
      <text>“Nurse practitioner” means a registered nurse who is certified:</text>
      <paragraph num="(a)">
        <text>By the Maryland Board of Nursing to engage in the activities specified in COMAR 10.27.07; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>As a nurse practitioner in a jurisdiction bordering Maryland under the laws of that jurisdiction.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(25)">
      <text>“Participating medical provider under the Breast and Cervical Cancer Program” means a health care provider who has entered into a written agreement with a local health department or the private entity that contracts with the Department to render services in Baltimore City and Calvert County under the Breast and Cervical Cancer Program to provide breast cancer services to an enrollee.</text>
    </paragraph>
    <paragraph num="(26)">
      <text>“Participating medical provider under the Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment Program” means any of the following:</text>
      <paragraph num="(a)">
        <text>A physician who meets the requirements of COMAR 10.14.02.04A;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A nurse practitioner who meets the requirements of COMAR 10.14.02.05A;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A nurse anesthetist who meets the requirements of COMAR 10.14.02.06A;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A physical therapist who meets the requirements of COMAR 10.14.02.07A;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>A pharmacy that meets the requirements of COMAR 10.14.02.08A;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>A hospital that meets the requirements of COMAR 10.14.02.09A;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>A medical supply company that meets the requirements of COMAR 10.14.02.10A;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>A home health service provider that meets the requirements of COMAR 10.14.02.11A;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>A medical laboratory that meets the requirements of COMAR 10.14.02.12A; or</text>
      </paragraph>
      <paragraph num="(j)">
        <text>A free-standing ambulatory surgical center that meets the requirements of COMAR 10.14.02.13A.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(27)">
      <text>“Pharmacy” means an establishment or institution that holds a permit to provide pharmacy services under Health Occupations Article, Title 12, Subtitle 4, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(28)">
      <text>“Physical therapist” means an individual who is licensed or registered to practice physical therapy:</text>
      <paragraph num="(a)">
        <text>In Maryland under Health Occupations Article, Title 13, Subtitle 3, Annotated Code of Maryland; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>In a jurisdiction bordering Maryland under the laws of that jurisdiction.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(29)">
      <text>“Physician” means an individual who is licensed to practice medicine:</text>
      <paragraph num="(a)">
        <text>In Maryland under Health Occupations Article, Title 14, Subtitle 3, Annotated Code of Maryland; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>In a jurisdiction bordering Maryland under the laws of that jurisdiction.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(30)">
      <text>“Recipient of service” means an enrollee who has received a covered service under this chapter.</text>
    </paragraph>
    <paragraph num="(31)">
      <text>“Registered nurse” means an individual who is licensed to practice registered nursing:</text>
      <paragraph num="(a)">
        <text>In Maryland under Health Occupations Article, Title 8, Subtitle 3, Annotated Code of Maryland; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>In a jurisdiction bordering Maryland under the laws of that jurisdiction.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(32)">
      <text>“Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment Program” means the program operated by the Department to pay for breast and cervical cancer diagnostic and treatment procedures for eligible women under COMAR 10.14.02.</text>
    </paragraph>
    <paragraph num="(33)">
      <text>“Resident” means an individual who is currently residing in Maryland.</text>
    </paragraph>
    <paragraph num="(34)">
      <text>“Screening” means a medical test to detect cancer.</text>
    </paragraph>
    <paragraph num="(35)">
      <text>“Surgical consult” means a consultation with a surgeon for advice on the recommended follow-up of the results of screening tests that are not considered normal.</text>
    </paragraph>
    <paragraph num="(36)">
      <text>“Treatment” means the medical management and care of a patient for breast cancer.</text>
    </paragraph>
    <paragraph num="(37)">
      <text>“Ultrasound” means a medical test in which high frequency sound waves are used to make an image of a specific area of the breast to determine if a breast lump is a fluid-filled cyst or a solid mass.</text>
    </paragraph>
  </paragraph>
</regulation>