37.55.101    DEFINITIONS

(1) "Claimant" means a person applying for assistance from the ESRD.

(2) "End stage renal disease" means severe kidney disease or kidney failure which is irreversible and permanent, and which requires dialysis or kidney transplantation to control uremia and maintain life.

(3) "EOB" means an explanation of benefit form.

(4) "ESRD" means the end-stage renal disease program administered by the department pursuant to chapter 692 of the 1983 session laws.

(5) "Family unit" means the individuals who are dependent upon a common primary source of financial support, including, but not limited to:

(a) the claimant,

(b) the claimant's spouse,

(c) the claimant's natural or adopted children under 18 years of age, and

(d) when the claimant is under 18 years of age, the claimant's natural or adoptive parents and the claimant's siblings living with them.

(6) "Third party" means a public or private agency which is or may be liable to pay all or part of the medical costs of a claimant, including, but not limited to, medicare (Title XVIII of the Social Security Act) , medicaid (Title XIX of the Social Security Act) , a county fund for the medically needy, private insurance (including group health, private health, or family health carried by an absent parent, if applicable) , the veteran's administration, CHAMPUS (civilian health and medical program of the uniformed services) , the Indian health service of the U.S. public health service, and the rehabilitative services of the department of public health and human services.

History: Sec. 50-44-102 and 53-6-202, MCA; IMP, Sec. 50-44-102 and 53-6-202, MCA; NEW, 1984 MAR p. 41, Eff. 1/13/84; TRANS & AMD, from DHES, 2000 MAR p. 1660, Eff. 6/30/00.