Terms Used In California Codes > Health and Safety Code > Division 107 > Part 2 > Chapter 2.6 - Health Care Affordability

• Administrative costs and profits: means the total sum of all expenses not included in the numerator of the medical loss ratio calculation under state or federal law, including, but not limited to, all of the following:

  California Health and Safety Code 127500.2

• Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
• Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
• Affordability for consumers: means considering the totality of costs paid by consumers for covered benefits, including the enrollee share of premium and cost-sharing amounts paid towards the maximum out-of-pocket amount, including deductibles, copays, coinsurance, and other forms of cost sharing for public and private health coverage. See California Health and Safety Code 127500.2
• Allegation: something that someone says happened.
• Alternative payment model: means a state or nationally recognized payment approach that financially incentivizes high-quality and cost-efficient care. See California Health and Safety Code 127500.2
• Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
• Amortization: Paying off a loan by regular installments.
• Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Appellate: About appeals; an appellate court has the power to review the judgement of another lower court or tribunal.
• Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
• Arrest: Taking physical custody of a person by lawful authority.
• Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
• Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
• Board: means the Health Care Affordability Board established by Section 127501. See California Health and Safety Code 127500.2
• Chambers: A judge's office.
• Codicil: An addition, change, or supplement to a will executed with the same formalities required for the will itself.
• Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Complaint: means a complaint or cross-complaint. See California Code of Civil Procedure 426.10
• Continuance: Putting off of a hearing ot trial until a later time.
• Contract: A legal written agreement that becomes binding when signed.
• Conviction: A judgement of guilt against a criminal defendant.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• Counterclaim: A claim that a defendant makes against a plaintiff.
• county: includes "city and county". See California Penal Code 7
• Decedent: A deceased person.
• Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
• Deposition: An oral statement made before an officer authorized by law to administer oaths. Such statements are often taken to examine potential witnesses, to obtain discovery, or to be used later in trial.
• Director: means the Director of the Department of Health Care Access and Information. See California Health and Safety Code 127500.2
• Director: means Director of Industrial Relations. See California Labor Code 20
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Docket: A log containing brief entries of court proceedings.
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Exempted provider: means a provider that meets standards established by the board for exemption from either of the following:

  California Health and Safety Code 127500.2

• Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
• Fraud: Intentional deception resulting in injury to another.
• Fully integrated delivery system: means a system that includes a physician organization, health facility or health system, and a nonprofit health care service plan that provides health care services to enrollees in a specific geographic region of the state through an affiliate hospital system and an exclusive contract between the nonprofit health care service plan and a single physician organization in each geographic region to provide those medical services. See California Health and Safety Code 127500.2
• Health care cost target: means the target percentage for the maximum annual increase in per capita total health care expenditures. See California Health and Safety Code 127500.2
• Health care entity: means a payer, provider, or a fully integrated delivery system. See California Health and Safety Code 127500.2
• Impeachment: (1) The process of calling something into question, as in "impeaching the testimony of a witness." (2) The constitutional process whereby the House of Representatives may "impeach" (accuse of misconduct) high officers of the federal government for trial in the Senate.
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• Insurance market: means the public and private health insurance markets. See California Health and Safety Code 127500.2
• Intestate: Dying without leaving a will.
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Lawsuit: A legal action started by a plaintiff against a defendant based on a complaint that the defendant failed to perform a legal duty, resulting in harm to the plaintiff.
• Lien: A claim against real or personal property in satisfaction of a debt.
• Line of business: means the different individual, small, and large group business lines, as defined in Section 1348. See California Health and Safety Code 127500.2
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Material change: means any change in ownership, operations, or governance for a health care entity, involving a material amount of assets of a health care entity. See California Health and Safety Code 127500.2
• month: means a calendar month, unless otherwise expressed. See California Penal Code 7
• Oath: includes affirmation. See California Military and Veterans Code 15
• Oath: A promise to tell the truth.
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Oversight: Committee review of the activities of a Federal agency or program.
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Payer: means private and public health care payers, including all of the following:

  California Health and Safety Code 127500.2

• Person: means any person, association, organization, partnership, business trust, limited liability company, or corporation. See California Insurance Code 19
• Person: means any person, association, organization, partnership, business trust, limited liability company, or corporation. See California Labor Code 18
• Person: includes a corporation as well as a natural person. See California Code of Civil Procedure 17
• person: includes a corporation as well as a natural person. See California Penal Code 7
• Person: includes any person, firm, partnership, association, corporation, company, limited liability company, syndicate, estate, trust, business trust, or organization of any kind. See California Financial Code 18
• Personal property: All property that is not real property.
• Personal property: includes money, goods, chattels, things in action, and evidences of debt. See California Code of Civil Procedure 17
• Physician organization: includes any of the following:

  California Health and Safety Code 127500.2

• Plaintiff: The person who files the complaint in a civil lawsuit.
• Plaintiff: means a person who files a complaint or cross-complaint. See California Code of Civil Procedure 426.10
• Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Process: signifies a writ or summons issued in the course of a judicial proceeding. See California Code of Civil Procedure 17
• Property: includes both personal and real property. See California Code of Civil Procedure 17
• property: includes both real and personal property. See California Penal Code 7
• Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
• Provider: means any of the following that delivers or furnishes health care services:

  California Health and Safety Code 127500.2

• Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• Purchaser: means an individual, organization, or business entity that purchases health care services, including, but not limited to, trust funds, trade associations, and private and public employers who provide health care benefits to their employees, members, and dependents. See California Health and Safety Code 127500.2
• Quorum: The number of legislators that must be present to do business.
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• Related cause of action: means a cause of action which arises out of the same transaction, occurrence, or series of transactions or occurrences as the cause of action which the plaintiff alleges in his complaint. See California Code of Civil Procedure 426.10
• Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
• Remand: When an appellate court sends a case back to a lower court for further proceedings.
• seal: includes an impression of such seal upon the paper alone, or upon any substance attached to the paper capable of receiving a visible impression. See California Penal Code 7
• Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
• State: includes the District of Columbia and the territories when applied to the different parts of the United States, and the words "United States" may include the district and territories. See California Code of Civil Procedure 17
• state: when applied to the different parts of the United States, includes the District of Columbia and the territories, and the words "United States" may include the district and territories. See California Penal Code 7
• Statute: A law passed by a legislature.
• Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
• Subpoena: A command to a witness to appear and give testimony.
• subscription: includes mark when the signer or subscriber cannot write, such signer's or subscriber's name being written near the mark by a witness who writes his own name near the signer's or subscriber's name. See California Military and Veterans Code 17
• Summons: Another word for subpoena used by the criminal justice system.
• Testate: To die leaving a will.
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Total health care expenditures: means all health care spending in the state by public and private sources, including all of the following:

  California Health and Safety Code 127500.2

• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
• Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. ^{Source: OCC}
• Trustee: A person or institution holding and administering property in trust.
• vessel: means a vessel as defined in subdivision (c) of §. See California Penal Code 7
• war: shall mean : (a) whenever Congress has declared war and peace has not been formally restored. See California Military and Veterans Code 18
• Will: includes codicil. See California Code of Civil Procedure 17
• Writ: A formal written command, issued from the court, requiring the performance of a specific act.
• Writ: means an order or precept in writing, issued in the name of the people, or of a court or judicial officer. See California Code of Civil Procedure 17
• Writing: includes printing and typewriting. See California Code of Civil Procedure 17