Definitions

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53-4-1103. Definitions. For purposes of part 10 and this part, the following definitions apply:

(1) "Comprehensive" means health insurance having benefits at least as extensive as those provided under the children's health insurance program.

(2) "Department" means the department of public health and human services provided for in 2-15-2201.

(3) "Enrollee" means a child who is enrolled or in the process of being enrolled in the plan, including children already enrolled in the programs described in 53-4-1104(2).

(4) (a) "Enrollment partner" means an organization or individual approved by the department to assist in enrolling eligible children in the plan.

(b) An enrollment partner may be but is not limited to:

(i) a licensed health care provider;

(ii) a school;

(iii) a community-based organization; or

(iv) a government agency.

(5) "Habilitative services" means services to help a child maintain, learn, or improve skills and functioning for daily living or to prevent deterioration of skills and that may be offered in a variety of settings. The services include but are not limited to:

(a) physical therapy;

(b) occupational therapy;

(c) speech-language pathology; and

(d) behavioral health treatment, including applied behavior analysis provided by a board-certified behavior analyst.

(6) "Health coverage" means a program administered by the department or a disability insurance plan, referred to in 33-1-207(1)(b), that provides public or private health insurance for children.

(7) "Income" has the meaning provided in 15-30-2337(9)(a).

(8) "Plan" means the healthy Montana kids plan established in 53-4-1104.

(9) "Premium" means the amount of money charged to provide coverage under a public or private health coverage plan.

(10) "Presumptive eligibility" has the meaning provided in 42 CFR 457.355.

History: En. Sec. 3, I.M. No. 155, approved Nov. 4, 2008; amd. Sec. 2, Ch. 399, L. 2017.


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