General Definitions

As used in 101 CMR 313.00, unless the context clearly otherwise requires, the following terms have the meanings in 101 CMR 313.02. Ambulatory Abortion or Sterilization Clinic. A state-licensed freestanding ambulatory clinic that provides abortion or sterilization services and which is in compliance with applicable clinic licensure rules and regulations. Center. The Center for Health Information and Analysis established under M.G.L. c. 12C. Eligible Provider. State-licensed freestanding ambulatory abortion or sterilization clinics providing abortion and/or sterilization services which meet such conditions of participation as may be required by a governmental unit purchasing such services. EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A. Established Patient. A patient who has received professional services from the provider within the past three years. Governmental Unit. The Commonwealth, any department, agency, board, or commission of the Commonwealth and any political subdivision of the Commonwealth. Individual Consideration (IC). For specified drugs and injectables listed in 101 CMR 313.03(5) with IC, payment will be at cost, subject to any documentation requirements of the governmental unit. Modifier. Listed services and procedures may be modified under certain circumstances. When applicable, the modifying circumstances must be identified by the addition of the appropriate two letter or numeric designation. Publicly Aided Individual. A person for whose medical and other services a governmental unit is in whole or in part liable under a statutory program.