<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".01" citation="COMAR 10.20.01.01" title_num="10" subtitle_num="20" chapter_num="01" 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 individual who has applied for, or is in the process of applying for, Kidney Disease Program enrollment and has not yet been certified as an eligible recipient.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Certification period” means the 12-month period during which an individual is certified as eligible to receive Kidney Disease Program benefits.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Certified facility” means a hospital, dialysis facility, or transplantation center which the Department certifies meets the standards that the Commission adopts for providing services to recipients and which is certified by Medicare.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Commission” means the State Commission on Kidney Disease.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Department” means the Maryland Department of Health.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Dialysis” means chronic hemodialysis or chronic peritoneal dialysis provided in a certified facility or a facility approved by the Commission or in the patient's home under the auspices of a certified facility or home dialysis program approved by the Commission.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“End stage renal disease (ESRD)” means that stage of renal impairment that appears irreversible and permanent, and requires a regular course of maintenance dialysis or kidney transplantation to maintain life.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Family” means the recipient and all of the following individuals sharing the same household with the recipient:</text>
      <paragraph num="(a)">
        <text>The recipient's spouse;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The recipient's natural or adopted children who are younger than 21 years old;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The recipient's natural or adoptive parent, if the recipient is a child younger than 21 years old; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The recipient's stepchildren or grandchildren for which the recipient has legal or presumed guardianship.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>“Liquid assets” means cash or an asset that can readily be converted to cash.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Medical Assistance” means the State program of comprehensive medical and other health-related care for indigent and medically indigent persons.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Medicare” means the insurance program administered by the federal government under Title XVIII of the Social Security Act, 42 U.S.C. §1395 et seq.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Poverty income guidelines” means the federal poverty income guidelines contained in the most recent annual update of the Department of Health and Human Services poverty income guidelines as published in the Federal Register.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Preauthorization” means an approval required from the Program before services are rendered to a recipient.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Primary Adult Care Program (PAC)” has the meaning stated in COMAR 10.09.60.02.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Program” means the Kidney Disease Program of Maryland.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Program participation fee” means an annual premium which may be assessed by the Program and is based on family income or liquid assets, or both.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Provider” means an individual, association, partnership, corporation, or unincorporated group licensed or certified to provide health care services for Program recipients.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Qualified alien” means an alien who:</text>
      <paragraph num="(a)">
        <text>Has been fully admitted for permanent residence in the United States under the Immigration and Nationality Act (INA);</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has been granted asylum in the United States under §208 of the INA;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Has been admitted into the United States as a refugee under §207 of the INA;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Has been paroled into the United States under §212(d)(5) of the INA for a period of at least 1 year;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Has had deportation withheld under §243(h) of the INA; or</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Has been granted conditional entry into the United States under §203(a)(7) of the INA in effect before April 1, 1980.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(19)">
      <text>“Quarterly amount” means the quarterly installment payment which is equal to 25 percent of a recipient's annual Program participation fee.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Recipient” means an individual who is certified for enrollment in the Kidney Disease Program of Maryland.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Reimbursable drug list” means the Kidney Disease Program formulary of medications approved for payment.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Representative” means an individual who, because of an applicant's or a recipient's mental or physical incapacity or youth, or specified dialysis or transplant facility personnel who have been so designated by virtue of the applicant's or recipient's voluntarily signed authorization form, is authorized, in accordance with State law, to complete, sign, or withdraw an application for enrollment in the Program or to activate a hearing process.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>Resident.</text>
      <paragraph num="(a)">
        <text>“Resident” means an individual permanently living in Maryland whose temporary absence from the State does not interrupt continuity of residence.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Resident” does not mean:</text>
        <paragraph num="(i)">
          <text>Members or their families, or both, of the United States armed services temporarily stationed in Maryland; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Foreign nationals employed in embassies of their native country.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>