"Health maintenance organization (HMO)"
means an entity licensed by the office of the insurance commissioner to provide comprehensive medical services directly to an eligible enrolled client in exchange for a premium paid by the agency on a prepaid capitation risk basis. "Health care professional"
means a provider of health care services licensed or certified by the state in which they practice. Health care service category"
means a grouping of health care services listed in the table in WAC 388-501-0060
. A health care service category is included or excluded depending on the client's medical assistance benefits package. "Home health agency"
means an agency or organization certified under medicare to provide comprehensive health care on a part-time or intermittent basis to a patient in the patient's place of residence. "Hospital"
means an entity that is licensed as an acute care hospital in accordance with applicable state laws and rules, or the applicable state laws and rules of the state in which the entity is located when the entity is out-of-state, and is certified under Title XVIII of the federal Social Security Act. The term "hospital" includes a medicare or state-certified distinct rehabilitation unit or a psychiatric hospital.
[11-14-075, recodified as § 182-500-0045, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 2011 1st sp.s. c 15. 11-14-053, § 388-500-0045, filed 6/29/11, effective 7/30/11.]