(A) "Applicant" means an individual whose written application for Medicaid has been submitted to the agency determining medicaid eligibility, but has not received final action. This includes an individual (living or deceased) whose application is submitted by a representative or a person acting responsibly for the individual.
(B) "Commission" means the State Health and Human Services Finance Commission.
(C) "Medicaid" means the medical assistance program authorized by Title XIX of the Social Security Act and administered by the State Health and Human Services Finance Commission.
(D) "Person" means any natural person, company, association, partnership, corporation, or any other legal entity.
(E) "Practitioner" means a physician or other health care professional licensed under state law to practice his profession.
(F) "Private Insurer" means:
(1) a commercial insurance company offering health or casualty insurance to individuals or groups, including experienced-rated contracts and indemnity contracts;
(2) a profit or nonprofit prepaid plan offering either medical services or full or partial payment for the diagnosis or treatment of an injury, disease, or disability;
(3) an organization administering health or casualty insurance plans for professional associations, unions, fraternal groups, employer-employee benefit plans, and any similar organization offering these plans or services, including self-insured and self-funded plans; or
(4) a group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, a service benefit plan, or a health maintenance organization.
(G) "Provider" means an individual, firm, corporation, association, institution, or other legal entity which is providing, or has been approved to provide, medical assistance to a recipient pursuant to the State Medical Assistance Plan and in accord with Title XIX of the Social Security Act-Medical Assistance (Medicaid).
(H) "Recipient" means an individual who has been determined to be eligible for health services as described in the State Medical Assistance Plan in accord with Title XIX of the Social Security Act-Medical Assistance (Medicaid).
(I) "Third Party" means any individual, entity, or program that is or may be liable to pay all or part of the medical cost of injury, disease, or disability of an applicant or recipient.