Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.02 - Definitions

Current through June 24, 2024
In this chapter:
(1)
				"Agreement" means a written document executed between an ESRD unit and another
				unit, in which the other unit agrees to assume responsibility for furnishing
				specified services to patients and for obtaining reimbursement for those
				services.
(2) "Arrangement" means a
				written document executed between an ESRD unit and another unit, in which the
				other unit agrees to furnish specified services to patients but the ESRD unit
				retains responsibility for the services and for obtaining
				reimbursement.
(2m) "BadgerCare"
				means the medical assistance-related program established under s.
				49.665, Stats., and
				chs.
				DHS
				101 to 108.
(3) "Chronic renal disease" or "CRD" means
				that stage of renal impairment which is virtually irreversible and requires a
				regular course of dialysis or kidney transplantation to maintain
				life.
(4) "CRD program advisory
				committee" means the committee appointed by the department under s.
				DHS
				152.09.
(4m) "Current year" means the 12-month period
				beginning with the month of a patient's first application to the CRD program,
				or beginning with the month of a certified patient's subsequent annual
				recertification for the CRD program.
(5) "Department" means the department of
				health services.
(6) "Dialysis"
				means a process by which dissolved substances are removed from a patient's body
				by diffusion and osmosis from one fluid compartment to another across a
				semipermeable membrane.
(7)
				"Dietitian" means a person who is eligible for registration by the American
				dietetic association and has at least 1 year of experience in clinical
				nutrition, or a person who has a baccalaureate or advanced degree with major
				studies in food and nutrition or dietetics and at least 1 year of experience in
				clinical nutrition.
(8) "End-stage
				renal disease" or "ESRD" has the meaning prescribed for chronic renal disease
				or CRD in sub. (3).
(9) "ESRD unit"
				or "unit" means a free-standing or hospital-based renal dialysis facility, a
				renal dialysis center or a renal transplantation center.
(9m) "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.
(9t) "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.
(9u) "Fiscal agent" means
				the organization under contract to the department to process claims and
				determine eligibility for services provided under the CRD program.
(10) "Free-standing renal dialysis facility"
				means a non-hospital unit which is approved by the department under this
				chapter to furnish chronic maintenance dialysis with or without self-care
				dialysis training.
(11) "Furnishes
				directly" means that the ESRD unit provides the service through its own staff
				and employees, or through individuals who are under personal contract to
				furnish services for the facility.
(12) "Home dialysis" means dialysis performed
				by a trained ESRD patient or helper, or both, at home.
(13) "Hospital-based renal dialysis facility"
				means a hospital unit approved by the department to furnish one or more of the
				following dialysis services to ESRD patients:
(a) Outpatient dialysis;
(b) Inpatient dialysis;
(c) Home dialysis;
(d) Self-dialysis training.