1. (1)(a) "Board of directors" means a local board of directors for an independent hospital that is directly responsible for the daily policy and financial decisions of the hospital.

   1. (b) A board of directors does not include a corporate board of directors for an entity that owns an independent hospital.

2. (2)(a) "Local practice location" means a provider's office where services are provided.

   1. (b) A local practice location is:

      1. (i) permanently located within a county with a population density of:

         1. (A) less than 100 people per square mile before December 31, 2000; or
         2. (B) less than 30 people per square mile; and

      2. (ii) within 30 miles of paved roads of:

         1. (A) the place where an enrollee lives or resides; or
         2. (B) the location of an independent hospital or federally qualified health center where an enrollee may receive health care services.
3. (3) "Policy and financial decision" means a day-to-day decision made by a board of directors regarding an independent hospital's policy and financial solvency.

4. (4) "Provider" means a person who:

   1. (a) furnishes health care directly to an enrollee; and
   2. (b) is licensed or authorized to furnish health care.

5. (5) "Referral" means:

   1. (a) a request by a health care provider for an item, service, test, or procedure to be performed by another health care provider;
   2. (b) a request by a physician for a consultation with another physician; or
   3. (c) a request to establish a plan of care by a physician.
6. (6) "Rural county" means a county with a population density of less than 100 people per square mile.

Terms used in this rule are defined in Sections 31A-1-301 and 31A-45-102. Additional terms are defined as follows:

KEY: health care providers

Date of Last Change: June 21, 2023

Notice of Continuation: August 12, 2021

Authorizing, and Implemented or Interpreted Law: 31A-2-201; 31A-45-501