The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise:
"Agreement with the Department of Human Services."As follows:
(1) An agreement between an MA or CHIP managed care plan and the Department of Human Services to manage the purchase and provision of services.
(2) The term includes a county or multicounty agreement with the Department of Human Services for behavioral health services.
"Asynchronous interaction."An exchange of information between a patient and a health care provider that does not occur in real time, including the secure collection and transmission of a patient's medical information, clinical data, clinical images, laboratory results and self-reported medical history.
"Children's Health Insurance Program"or"CHIP."The Children's Health Insurance Program under Article XXIII-A of the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921.
"Enrollee."An individual who is entitled to receive health care services under an agreement with the Department of Human Services.
"Health care facility."As follows:
(1) An entity that is licensed to provide a health care service under Article X of the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, or the act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act.
(2) A federally qualified health center as defined in 42 U.S.C. § 1395x(aa)(4) (relating to definitions).
(3) A rural health clinic as defined in 42 U.S.C. § 1395xx(aa)(2).
"Health care provider."A health care facility, medical equipment supplier or person that is licensed, certified or otherwise regulated to provide health care services under the laws of this Commonwealth or another state.
"Health care service."Any treatment, admission, procedure, medical supplies and equipment or other services, including behavioral health, prescribed or otherwise provided or proposed to be provided by a health care provider to a patient for the diagnosis, prevention, treatment, cure or relief of a health condition, illness, injury or disease.
"Health Information Technology for Economic and Clinical Health Act."The Health Information Technology for Economic and Clinical Health Act (Public Law 111-5, 123 Stat. 226-279 and 467-496).
"Health insurance policy."As follows:
(1) A policy, subscriber contract, certificate or plan issued by an insurer that provides medical or health care coverage.
(2) The term includes a dental only and a vision only policy.
(3) The term does not include:
(i) An accident only policy.
(ii) A credit only policy.
(iii) A long-term care or disability income policy.
(iv) A specified disease policy.
(v) A Medicare supplement policy.
(vi) A TRICARE policy, including a Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement policy.
(vii) A fixed indemnity policy.
(viii) A hospital indemnity policy.
(ix) A worker's compensation policy.
(x) An automobile medical payment policy under 75 Pa.C.S. (relating to vehicles).
(xi) A homeowner's insurance policy.
(xii) Any other similar policies providing for limited benefits.
"Health Insurance Portability and Accountability Act of 1996."The Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191, 110 Stat. 1936).
"Insurer."An entity licensed by the department that offers, issues or renews a health insurance policy and is governed under any of the following:
(1) The Insurance Company Law of 1921, including section 630 and Article XXIV of that act.
(2) The act of December 29, 1972 (P.L.1701, No.364), known as the Health Maintenance Organization Act.
(3) Chapter 61 (relating to hospital plan corporations).
(4) Chapter 63 (relating to professional health services plan corporations).
"Medical assistance"or"MA."The Medical Assistance Program established under Article IV of the Human Services Code.
"Medical Assistance or Children's Health Insurance Program managed care plan"or"MA or CHIP managed care plan."A health care plan that uses a gatekeeper to manage the utilization of health care services by medical assistance or children's health insurance program enrollees and integrates the financing and delivery of health care services.
"Medical policy."As defined in section 2102 of The Insurance Company Law of 1921.
"Participating network provider."A health care provider that has entered a contractual or operating relationship with an insurer or MA or CHIP managed care plan to participate in one or more networks of the insurer or MA or CHIP managed care plan to provide health care services under the terms of a health insurance policy or an agreement with the Department of Human Services.
"Remote patient monitoring."The collection and monitoring of physiological data from a patient in one location, which is transmitted via an electronic communication technology to a health care provider in a different location for use in care and related support of the patient.
"State."A state of the United States, the District of Columbia, the Commonwealth of Puerto Rico and any territory or possession of the United States.
"Synchronous interaction."A two-way or multiple-way exchange of information between a patient and a health care provider that occurs in real time via audio or video conferencing.
"Telemedicine."The delivery of health care services to a patient by a health care provider who is at a different location, through synchronous interactions, asynchronous interactions or remote patient monitoring that meets the requirements of the Health Insurance Portability and Accountability Act of 1996, the Health Information Technology for Economic and Clinical Health Act or other applicable Federal law or law of this Commonwealth regarding the privacy and security of electronic transmission of health information.