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