Terms Used In Nebraska Statutes > Out-of-Network Emergency Medical Care Act

• Acquire: when used in connection with a grant of power or property right to any person shall include the purchase, grant, gift, devise, bequest, and obtaining by eminent domain. See Nebraska Statutes 49-801
• Action: shall include any proceeding in any court of this state. See Nebraska Statutes 49-801
• 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
• Contract: A legal written agreement that becomes binding when signed.
• Covered person: means a person on whose behalf an insurer is obligated to pay health care expense benefits or provide health care services. See Nebraska Statutes 44-6836
• Deed: The legal instrument used to transfer title in real property from one person to another.
• Department: shall mean the Department of Insurance. See Nebraska Statutes 44-103
• Devise: To gift property by will.
• Emergency medical condition: means a medical or behavioral condition, the onset of which is sudden, that manifests itself by symptoms of sufficient severity, including, but not limited to, severe pain, that a prudent layperson, possessing an average knowledge of medicine and health, could reasonably expect the absence of immediate medical attention to result in (1) placing the health of the person afflicted with such condition in serious jeopardy or, in the case of a behavioral condition, placing the health of such persons or others in serious jeopardy, (2) serious impairment to such person's bodily functions, (3) serious impairment of any bodily organ or part of such person, or (4) serious disfigurement of such person. See Nebraska Statutes 44-6837
• Emergency services: means health care services medically necessary to screen and stabilize a covered person in connection with an emergency medical condition. See Nebraska Statutes 44-6838
• 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.
• Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
• Health benefits plan: means a benefits plan which pays or provides hospital and medical expense benefits for covered services and is delivered or issued for delivery in this state by or through an insurer. See Nebraska Statutes 44-6839
• Health benefits plan does not: include the medical assistance program, medicare, medicare advantage, accident-only, credit, disability, or long-term care coverage, TRICARE supplement coverage, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance, personal injury protection insurance, and hospital confinement indemnity coverage. See Nebraska Statutes 44-6839
• Health care facility: means a general acute hospital, satellite emergency department, or ambulatory surgical center licensed pursuant to the Health Care Facility Licensure Act. See Nebraska Statutes 44-6840
• Health care professional: means an individual who is credentialed pursuant to the Uniform Credentialing Act, who is acting within the scope of his or her credential, and who provides a covered service defined by the health benefits plan. See Nebraska Statutes 44-6841
• Health care provider: means a health care professional or health care facility. See Nebraska Statutes 44-6842
• Insurer: means an entity that contracts to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefits plan, including (1) any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or surgical expense-incurred policy, except for a policy that provides coverage for a specified disease or other limited-benefit coverage, and (2) any self-funded employee benefit plan to the extent not preempted by federal law. See Nebraska Statutes 44-6843
• Insurer shall: include all companies, exchanges, societies, or associations whether organized on the stock, mutual, assessment, or fraternal plan of insurance and reciprocal insurance exchanges. See Nebraska Statutes 44-103
• Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). ^{Source: OCC}
• Medical assistance program: means the medical assistance program established pursuant to the Medical Assistance Act. See Nebraska Statutes 44-6844
• Medically necessary: means a health care service that a health care provider, exercising his or her prudent clinical judgment, would provide to a covered person for the purpose of evaluating, diagnosing, or treating an illness, an injury, or a disease, or its symptoms, and that is in accordance with the generally accepted standards of medical practice. See Nebraska Statutes 44-6845
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• Person: shall include bodies politic and corporate, societies, communities, the public generally, individuals, partnerships, limited liability companies, joint-stock companies, and associations. See Nebraska Statutes 49-801
• Process: shall mean a summons, subpoena, or notice to appear issued out of a court in the course of judicial proceedings. See Nebraska Statutes 49-801
• Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• 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: when applied to different states of the United States shall be construed to extend to and include the District of Columbia and the several territories organized by Congress. See Nebraska Statutes 49-801
• TRICARE: means a health care program of the United States Department of Defense Military Health System. See Nebraska Statutes 44-6846
• United States: shall include territories, outlying possessions, and the District of Columbia. See Nebraska Statutes 49-801
• United States shall: include territories, outlying possessions, and the District of Columbia. See Nebraska Statutes 49-801
• Year: shall mean calendar year. See Nebraska Statutes 49-801