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Oklahoma Administrative Code (Last Updated: March 11, 2021) |
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TITLE 310. Oklahoma State Department of Health |
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Chapter 669. Trauma Care Assistance Revolving Fund |
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Subchapter 1. General Provisions |
SECTION 310:669-1-2. Definitions
Latest version.
- The following words or terms, when used in this Chapter, shall have the following meaning unless the context clearly indicates otherwise:"Ambulance service" means an entity licensed in accordance with 63 O.S. Supp. 2000, 1-2501, et seq."Bad debt" means the actual amount of uncollectible charges written off by a distribution entity, and arising from providing trauma care at an inpatient or outpatient facility, or transportation service, and that is calculated as the net of bad debt recoveries applied against bad debt expenses."Charity care" means trauma care at an inpatient or outpatient facility, or transportation services for which a distribution entity never expected to be reimbursed based on the distribution entity's determination of the patient's ability to pay based on the distribution entity's established standards."Commissioner" means the State Commissioner of Health."Cost report" means the latest annual reporting statement filed by a facility with its fiscal intermediary in compliance with requirements enforced by the Centers for Medicare and Medicaid Services."Cost to charge ratio" means the factor(s) calculated annually using information reported as part of a facility's cost report."Department" means the State Department of Health."Distribution entity" means an ambulance service or trauma facility that provided uncompensated care and reported the care respectively to the pre-hospital emergency medical service database in accordance with OAC 310:631-3-160(b), and the state trauma registry in accordance with OAC 310:669-3-1. This will also include physicians licensed in Oklahoma during the time the trauma care is provided."Fund" means the Trauma Care Assistance Revolving Fund."Gross revenues" means the charges for inpatient and outpatient services uniformly applied at the regular rates established to all patients by the distribution entity prior to the application of any adjustments, allowances, discounts, or revenue deductions."Medicare Allowed Reimbursement" means the allowed reimbursement established by the Centers for Medicare and Medicaid Services for the geographic location where inpatient or outpatient care is provided by a physician or transportation services are provided by a freestanding ambulance service."Run report" means the standard report form developed by the Commissioner to facilitate the collection of a standardized data set related to the provision of emergency medical and trauma care in accordance with 63 O.S. Section 1-2511."Tier A Physician" means a physician credentialed by the medical staff to provide emergency care to trauma patients in the specialties of emergency medicine, neurosurgery, general surgery, maxillo-facial surgery, orthopedic surgery, surgery specialties, anesthesiology, and trauma intensivists."Tier B Physician" means a physician credentialed by medical staff to provide care to trauma patients in a specialty area not defined in Tier A."Trauma" means bodily injury that produces injuries severe enough to cause disability or death."Trauma care" means treatment or transportation for treatment of a bodily injury that produces injures severe enough to cause disability or death."Trauma facility" means a hospital classified by the Department as providing a Level I, II, III, or IV Trauma and Emergency Operative Service."Trauma registry" means the statewide emergency medical services and trauma analysis system developed pursuant to the provisions of Section 1-2511 of Title 63 of the Oklahoma Statutes. [63:330.97]"Trauma team" means a specific team identified in policy and required to respond to the hospital to care for the traumatically injured within a specified period of time, monitored by a quality assurance process."Uncompensated care" means care provided for which expected payment was not received from the patient or insurer or any other identified payor source. Uncompensated care is the sum of a distribution entity's bad debt and charity care.