The following words and terms, when used in this subchapter,
have the following meanings unless the context clearly indicates otherwise.
(1) Affiliate--
(A) An individual or entity that has a legal relationship
with another entity, which relationship is created or governed by
at least one written instrument that demonstrates:
(i) common ownership, management, or control;
(ii) a franchise; or
(iii) the granting or extension of a license or other
agreement that authorizes the affiliate to use the other entity's
brand name, trademark, service mark, or other registered identification
mark.
(B) The written instruments referenced in subparagraph
(A) of this definition may include a certificate of formation, a franchise
agreement, standards of affiliation, bylaws, articles of incorporation
or a license, but do not include agreements related to a physician's
participation in a physician group practice, such as a hospital group
agreement, staffing agreement, management agreement, or collaborative
practice agreement.
(2) Applicant--An individual applying to receive services
under FPP, including a current client who is applying to renew.
(3) Budget group--Members of a household whose needs,
income, resources, and expenses are considered in determining eligibility.
(4) Client--Any individual seeking assistance from
an FPP health-care provider to meet their family planning goals.
(5) Contraceptive method--Any birth control option
approved by the United States Food and Drug Administration, with the
exception of emergency contraception.
(6) Contractor--An entity that HHSC has contracted
with to provide services. The contractor is the responsible entity,
even if a subcontractor provides the service.
(7) Corporate entity--A foreign or domestic non-natural
person, including a for-profit or nonprofit corporation, a partnership,
or a sole proprietorship.
(8) Covered service--A medical procedure for which
FPP will reimburse a contracted health-care provider.
(9) Elective abortion--The intentional termination
of a pregnancy by an attending physician who knows that the female
is pregnant, using any means that is reasonably likely to cause the
death of the fetus. The term does not include the use of any such
means:
(A) to terminate a pregnancy that resulted from an
act of rape or incest;
(B) in a case in which a female suffers from a physical
disorder, physical disability, or physical illness, including a life-endangering
physical condition caused by or arising from the pregnancy, that would,
as certified by a physician, place the female in danger of death or
risk of substantial impairment of a major bodily function unless an
abortion is performed; or
(C) in a case in which a fetus has a life-threatening
physical condition that, in reasonable medical judgment, regardless
of the provision of life-saving treatment, is incompatible with life
outside the womb.
(10) Family Planning Program (FPP)--The non-Medicaid
program administered by HHSC as outlined in this subchapter.
(11) Family Planning Program health-care provider--A
health-care provider that is contracted with HHSC and qualified to
perform covered services.
(12) Family planning services--Educational or comprehensive
medical activities that enable individuals to determine freely the
number and spacing of their children and to select the means by which
this may be achieved.
(13) Federal poverty level--The household income guidelines
issued annually and published in the Federal
Register by the United States Department of Health and Human
Services.
(14) Health-care provider--A physician, physician assistant,
nurse practitioner, clinical nurse specialist, certified nurse midwife,
federally qualified health center, family planning agency, health
clinic, ambulatory surgical center, hospital ambulatory surgical center,
laboratory, or rural health center.
(15) Health clinic--A corporate entity that provides
comprehensive preventive and primary health care services to outpatient
clients, which must include both family planning services and diagnosis
and treatment of both acute and chronic illnesses and conditions in
three or more organ systems. The term does not include a clinic specializing
in family planning services.
(16) HHSC--The Texas Health and Human Services Commission
or its designee.
(17) Medicaid--The Texas Medical Assistance Program,
a joint federal and state program provided for in Texas Human Resources
Code Chapter 32, and subject to Title XIX of the Social Security Act,
42 U.S.C. §1396 et seq.
(18) Minor--In accordance with the Texas Family Code,
a person under 18 years of age who has never been married and never
been declared an adult by a court (emancipated).
(19) Point of Service--The location where an individual
can receive FPP services.
(20) Third-party resource--A person or organization,
other than HHSC or a person living with the applicant or client, who
may be liable as a source of payment of the applicant's or client's
medical expenses (for example, a health insurance company).
(21) Unintended pregnancy--Pregnancy a female reports
as either mistimed or undesired at the time of conception.
(22) U.S.C.--United States Code.
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