Definitions

As used in this article, except as otherwise specifically provided or where the context indicates otherwise: 1. "Committee" means the health care data committee established in accordance with North Dakota Century Code chapter 23-01.1. 2. "Comprehensive health association of North Dakota members" means those insurance companies who are participating members in the North Dakota comprehensive health association as determined by the insurance commissioner under North Dakota Century Code section 26.1-08-03. 3. "Council" means the state health council as established under North Dakota Century Code section 23-01-02. 4. "Data supplier" means any insurer, nonprofit health service corporation, health maintenance organization, insured or self-funded group health plan, or state agency which pays for health benefits or provider services, health data clearinghouse, community health information network, or health care provider cooperative. 5. "Department" means the North Dakota state department of health. 6. "Diagnosis-related group" (DRG) means the categorizations established by the health care financing administration for the purposes of hospital payment and any subsequent similar set of categorizations so established. 7. "Group health plan" means an employee welfare benefit plan providing medical care as defined in 26 U.S.C. § 213(d), to participants or beneficiaries directly or through insurance, reimbursement, or otherwise. 8. "HCFA-1500" means the health care financing administration form 1500 or successor forms. 9. "Health maintenance organization" means any health maintenance organization certified by the North Dakota insurance department. 10. "Health professional data" means any claims for inpatient, outpatient, or ambulatory medical or surgical services or other services normally submitted to the third party payer on HCFA-1500 or successor forms or other forms specified by the committee. 11. "Hospital data" means any claims for inpatient, outpatient, or ambulatory surgical services or other services normally submitted to the third-party payer on form UB-92 or successor forms. 12. "Insurers" means any insurance company licensed to do business in North Dakota by the insurance department. 13. "Provider" means a person, agency, or organization which is engaged in the provision of health care to the public. 14. "UB-92" means the health care financing administration form UB-92 or successor forms.