[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR434.2]



[Page 110]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 434_CONTRACTS--Table of Contents

 

                      Subpart A_General Provisions

 

Sec.  434.2  Definitions.



    As used in this part, unless the context indicates otherwise--

    Fiscal agent means an entity that processes or pays vendor claims 

for the agency.

    Health care projects grant center means an entity that--

    (a) Is supported in whole or in part by Federal project grant 

financial assistance; and

    (b) Provides or arranges for medical services to recipients.

    Private nonmedical institution means an institution (such as a 

child-care facility or a maternity home) that--

    (a) Is not, as a matter of regular business, a health insuring 

organization or a community health care center;

    (b) Provides medical care to its residents through contracts or 

other arrangements with medical providers; and

    (c) Receives capitation payments from the Medicaid agency, under a 

nonrisk contract, for its residents who are eligible for Medicaid.

    Professional management service or consultant firm means a firm that 

performs management services such as auditing or staff training, or 

carries out studies or provides consultation aimed at improving State 

Medicaid operations, for example, with respect to reimbursement formulas 

or accounting systems.



[48 FR 54020, Nov. 30, 1983; 48 FR 55128, Dec. 9, 1983, as amended at 52 

FR 22322, June 11, 1987; 55 FR 51295, Dec. 13, 1990; 67 FR 41095, June 

14, 2002]