Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 154 - Reimbursement for treatment of adults with cystic fibrosis › Section DHS 154.02 - Definitions

Current through June 24, 2024
In this chapter:
(1)
				"Adult" means a person 18 years of age or older.
(1m) "BadgerCare" means the medical
				assistance-related program established under s.
				49.665, Stats., and
				chs.
				DHS
				101 to
				108.
(2) "Current year" means the later of the
				12-month period beginning with the month of a patient's first application to
				the adult cystic fibrosis program or the 12-month period beginning with the
				month of a participant's most recent subsequent annual recertification for the
				adult cystic fibrosis program.
(3)
				"Cystic fibrosis" means an inherited disorder of the exocrine or outward
				secreting glands of the body, causing those glands to produce abnormally thick
				secretions of mucus.
(4) "Cystic
				fibrosis treatment center" means a hospital unit which furnishes the full
				spectrum of diagnostic, therapeutic and rehabilitation services required for
				the care of cystic fibrosis patients and which is certified by the national
				cystic fibrosis foundation.
(5)
				"Department" means the Wisconsin department of health services.
(6) "Family" means a patient and that
				patient's spouse, if any, and any other person who is claimed as a dependent of
				that patient or that patient's spouse or who claims that patient as a dependent
				under the U.S. internal revenue code for the purpose of filing a federal income
				tax return.
(7) "Federal poverty
				guidelines" means the annually updated poverty income thresholds by family size
				published each year by the U.S. department of health and human services in the
				federal register.
Note: The federal poverty guidelines for 1999 were published
				  in the Federal Register, March 18, 1999, 13428.
(8) "Income" means a family's total earnings,
				including wages and salary and net income from self-employment, as well as
				unearned income, including social security and supplemental security income,
				dividends and interest income, income from estates or trusts, net rental
				income, public assistance, pensions or annuities, unemployment compensation,
				maintenance or alimony, child support or family support, nontaxable deferred
				compensation, and nontaxable interest such as interest on federal, state or
				municipal bonds, but not capital gains income.
(9) "Maintenance program" means a patient's
				therapeutic and treatment regimen, including medical, dental, social and
				vocational rehabilitation services and home health care.
(10) "Medical assistance" has the meaning
				specified in s.
				49.43(8),
				Stats.
(11) "Medical director"
				means a physician licensed under ch. 448, Stats., to practice medicine or
				osteopathy who is certified by the American board of internal medicine or is
				eligible for certification by that board, and who is directly responsible for a
				patient's maintenance program.
(12)
				"Medicare" means the health insurance program operated by the U.S. department
				of health and human services under
				42 USC
				1395 to
				1395
				zz and 42 CFR Pts. 405 to 421.
(13)
				"Participant" means a patient who has been found eligible by the department
				under s.
				49.683,
				Stats., and this chapter for reimbursement for the costs of treatment of cystic
				fibrosis.
(14) "Patient" means an
				adult who has been diagnosed as having cystic fibrosis.
(15) "Provider" means a cystic fibrosis
				treatment center or another source of treatment approved by the department
				under s.
				DHS
				154.05.
(16) "Resident" means any adult who is living
				in Wisconsin with the intention of remaining permanently in the
				state.
(17) "SeniorCare" means the
				program of prescription drug assistance for eligible elderly persons under s.
				49.688,
				Stats., and ch. DHS 109.