1499

1499.1

As used in this chapter, the following terms and phrases shall have the meanings ascribed:

Beneficiary - any individual who has received health-care assistance from the District and, if applicable, that individual’s guardian, conservator, personal representative, estate, dependents, and survivors.

Department - the D.C. Department of Healthcare Finance

Health-care assistance - the health or health-related care and treatment that the District has undertaken to provide free-of-charge or a discounted rate, or to pay for through Medicaid or the Medical Charities Program, or any other program and includes future care and treatment that the Department reasonably anticipates will be provided or paid for by the District. The term “Health-care assistance” includes medical, surgical, nursing, dental, hospital, nursing home, hospice and home care, prostheses and medical appliances, physical and occupational therapy, counseling and psychotherapy, social work, related transportation costs, and funeral and burial expenses.

Third party - a third-party tortfeasor, beneficiary’s insurer, or any other individual, organization, or entity, that is or may be liable to a beneficiary, in tort or contract, for all or part of the care and treatment the District has undertaken to provide or pay for as health-care assistance.

Unreimbursed value of health care assistance - the value or cost of the health and health-related care and services provided directly or through contract to the beneficiary by the District of Columbia.

SOURCE: Final Rulemaking published at 33 DCR 1320 (March 7, 1986); as amended by Final Rulemaking published at 37 DCR 4705 (July 20, 1990); as amended by Final Rulemaking published at 73 DCR 006110 (April 17, 2026).