§ 42-14.6-3. Definitions.
As used in this chapter, the following terms shall have the following meanings:
(1) "Commissioner� means the health insurance commissioner.
(2) "Health insurance plan� means any individual, general, blanket, or group policy of
health, accident and sickness insurance issued by a health insurer (as herein defined).
"Health insurance plan� shall not include insurance coverage providing benefits for:
(i) Hospital confinement indemnity;
(ii) Disability income;
(iii) Accident only;
(iv) Long-term care;
(v) Medicare supplement;
(vi) Limited benefit health;
(vii) Specified disease indemnity;
(viii) Sickness or bodily injury or death by accident or both; and
(ix) Other limited benefit policies.
(3) "Health insurer� means all entities licensed, or required to be licensed, in this
state that offer health benefit plans in Rhode Island including, but not limited to,
nonprofit hospital service corporations and nonprofit medical service corporations
established pursuant to chapters 19 and 20 of title 27, and health maintenance organizations
established pursuant to chapter 41 of title 27 or as defined in chapter 62 of this title, a fraternal benefit society, or any other
entity subject to state insurance regulation that provides medical care on the basis
of a periodic premium, paid directly or through an association, trust, or other intermediary,
and issued, renewed, or delivered within or without Rhode Island.
(4) "Patient-centered medical home� means a practice that satisfies the characteristics
described in § 42-14.6-2, and is designated as such by the secretary, or through alternative models as provided
for in § 42-14.6-7, based on standards recommended by the patient-centered medical home collaborative.
(5) "Patient-centered medical home collaborative� means a community advisory council,
including, but not limited to, participants in the existing Rhode Island patient-centered
medical home pilot project, and health insurers, physicians and other clinicians,
employers, the state healthcare program, relevant state agencies, community health
centers, hospitals, other providers, patients, and patient advocates which shall provide
consultation and recommendations to the secretary and the commissioner on all matters
relating to proposed regulations, development of standards, and development of payment
mechanisms.
(6) "Personal clinician� means a physician, physician assistant, or an advanced practice
nurse licensed by the department of health.
(7) "Secretary� means the secretary of the executive office of health and human services.
(8) "State healthcare program� means medical assistance, RIteCare, and any other health
insurance program provided through the office of health and human services (OHHS)
and its component state agencies; state healthcare program does not include any health
insurance plan provided as a benefit to state employees or retirees.