Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 153 - Reimbursement For Blood Products And Supplies UsedIn The Home Care Of Hemophilia › Section DHS 153.02 - Definitions

Current through June 24, 2024
In this chapter:
(1) "Approved source" means a provider who
				has an agreement with a comprehensive hemophilia treatment center for
				distribution of blood products and supplies to program participants.
(1m) "BadgerCare" means the medical
				assistance-related program established under s.
				49.665, Stats., and chs.
				DHS
				101 to
				108.
(2) "Case management services" means services
				essential for effective use of blood products and supplies, namely, home care
				initial training, nurse monitoring for participant compliance and annual
				comprehensive evaluation of a participant.
(3) "Comprehensive hemophilia treatment
				center" means a center, including its satellite facilities, certified by the
				department under this chapter to provide services, including development of
				maintenance programs, to persons with hemophilia and other related congenital
				bleeding disorders.
(4) "Current
				year" means the 12-month period beginning with the month of a patient's first
				application to the hemophilia home care program, or beginning with the month of
				a participant's subsequent annual recertification for the program.
(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) "Hemophilia" means a
				bleeding disorder resulting from a genetically determined clotting factor,
				protein or platelet function abnormality or deficiency.
(9) "Home care" means a patient's
				self-infusion of blood products on an outpatient basis, or the infusion of
				blood products to a patient on an outpatient basis by a person trained in that
				procedure.
(10) "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.
(11) "Maintenance program"
				means a patient's therapeutic and treatment regimen, including medical, dental,
				social and vocational rehabilitation services and home health care.
(11g) "Medical assistance" has the meaning
				specified in s. 49.43 (8),
				Stats., and chs.
				DHS
				101 to
				108.
(11r) "Medicare" means the health insurance
				program operated by the U.S. department of health and human services under
				42 USC
				1395 to
				1395zz and 42 CFR Pts. 405 to
				421.
(12) "Participant" means a
				patient who has been found eligible by the department under s.
				49.685, Stats., and this chapter
				for reimbursement for the costs of blood products and supplies used in the home
				care of hemophilia.
(13) "Patient"
				means a person diagnosed as having hemophilia.
(14) "Physician director" means the medical
				director of the comprehensive hemophilia treatment center which is directly
				responsible for a patient's maintenance program.
(15) "Program" means the hemophilia home care
				program under s. 49.685, Stats., and this
				chapter.
(16) "Provider" means a
				comprehensive hemophilia treatment center, an approved source of blood products
				and supplies or a provider of case management services for program
				participants.
(17) "Resident" means
				any person who is living in Wisconsin with the intention of remaining
				permanently in the state.
Note:
DWD 11.15 was repealed eff. 4-1-02.
(18) "SeniorCare" means the
				program of prescription drug assistance for eligible elderly persons under s.
				49.688, Stats., and ch. DHS
				109.