The following words and terms, where used in these sections, shall have the following meanings, unless the context clearly indicates otherwise.

1. (1) Act-The Texas Oral Health Improvement Act, Texas Civil Statutes, Article 4418g-2 (Senate Bill 894, 69th Legislature, 1985).
2. (2) Applicant-A person making applications for the program services, but for whom eligibility has not been established.
3. (3) Board-The Texas Board of Health.
4. (4) Bureau-The Bureau of Dental Health of the Texas Department of Health.
5. (5) Commissioner-The commissioner of health of the Texas Department of Health.
6. (6) Dentist-An individual licensed by the Texas State Board of Dental Examiners to practice dentistry in the State of Texas.
7. (7) Department-The Texas Department of Health.
8. (8) Eligible individual-An individual who meets the criteria established to receive oral health services from the department or a provider.
9. (9) Emergency care-Treatment for relief of pain and infection, including extractions and basic restorative services to prevent premature loss of teeth.
10. (10) Oral health services-Preventive or treatment services affecting the structures of the mouth, including the hard and soft tissues such as teeth and jaws, gums, vestibule, tongue, cheeks, lips, floor, roof of the mouth, and adjacent masticatory structures, and oral health education and promotion activities.

11. (11) Other benefit-A benefit to which an individual is entitled, other than a benefit provided under the Act, for the payment of the costs of oral health treatment services, including:

    1. (A) benefits available from:

       1. (i) an insurance policy, group oral health plan, or prepaid oral care plan;
       2. (ii) Title XVIII or Title XIX of the Social Security Act, Public Law 92-603, as amended;
       3. (iii) the Veteran's Administration;
       4. (iv) the Civilian Health and Medical Program of the Uniformed Services; or
       5. (v) worker's compensation or any other compulsory employer's insurance program;
    2. (B) a public program created by federal law, state law, or the ordinances or rules of a municipality or political subdivision of the state; or
    3. (C) benefits available to an individual applying for or receiving treatment services from the department arising out of a cause of action for dental or oral health treatment services expenses or a settlement or judgment based upon the cause of action, if the expenses are related to the need for treatment services provided under the Act.
12. (12) Person-An individual, corporation, government, or governmental subdivision or agency, business trust, partnership or association, or any other legal entity.
13. (13) Physician-An individual licensed by the Texas State Board of Medical Examiners to practice medicine in the State of Texas.
14. (14) Program-The oral health improvement services program administered by the bureau.
15. (15) Provider-A person who, through a contract with the department, furnishes oral health treatment services which are purchased by the department for the purpose of the Act. Providers will be categorized as either private or nonprivate. Private providers are licensed dentists or physicians who are reimbursed directly by the department for services rendered in accordance with the Act and these sections. Nonprivate providers are nonprofit organizations that are reimbursed for oral health services rendered other than on a fee-for-service basis.
16. (16) Regional dental director-The dental program director in a public health region of the department.
17. (17) Third-party nominator-A person who is aware of an applicant's economic condition, and includes school administrators, school nurses, social workers, city or county officials, public health clinics, community health centers, dentists, physicians, or hospitals.

Source Note:The provisions of this §49.2 adopted to be effective September 9, 1986, 11 TexReg 3793.