Terms Used In Utah Code > Title 26B > Chapter 3 > Part 3 - Administration of Medicaid Programs: Drug Utilization Review and Long Term Care Facility Certifica

• 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.
• Board: means the Drug Utilization Review Board created in Section 26B-3-302. See Utah Code 26B-3-301
• Certified program: means a nursing care facility program with Medicaid certification. See Utah Code 26B-3-301
• City: includes , depending on population, a metro township as defined in Section 10-3c-102. See Utah Code 68-3-12.5
• CMS: means the Centers for Medicare and Medicaid Services within the United States Department of Health and Human Services. See Utah Code 26B-3-101
• Compendia: means resources widely accepted by the medical profession in the efficacious use of drugs, including "American Hospital Formulary Service Drug Information" "U. See Utah Code 26B-3-301
• Contract: A legal written agreement that becomes binding when signed.
• 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.
• Counseling: means the activities conducted by a pharmacist to inform Medicaid recipients about the proper use of drugs, as required by the board under this part. See Utah Code 26B-3-301
• Criteria: means those predetermined and explicitly accepted elements used to measure drug use on an ongoing basis in order to determine if the use is appropriate, medically necessary, and not likely to result in adverse medical outcomes. See Utah Code 26B-3-301
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Division: means the Division of Integrated Healthcare within the department, established under Section 26B-3-102. See Utah Code 26B-3-101
• DUR: means the program designed to measure and assess, on a retrospective and prospective basis, the proper use of outpatient drugs in the Medicaid program. See Utah Code 26B-3-301
• 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.
• Executive director: means the executive director of the department appointed under Section 26B-1-203. See Utah Code 26B-1-102
• Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
• Fraud: Intentional deception resulting in injury to another.
• Highway: includes :Utah Code 68-3-12.5
• Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. ^{Source: FDIC}
• Intellectual disability: means a significant, subaverage general intellectual functioning that:Utah Code 68-3-12.5
• Intervention: means a form of communication utilized by the board with a prescriber or pharmacist to inform about or influence prescribing or dispensing practices. See Utah Code 26B-3-301
• 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.
• Land: includes :Utah Code 68-3-12.5
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Medicaid certification: means the right of a nursing care facility, as a provider of a nursing care facility program, to receive Medicaid reimbursement for a specified number of beds within the facility. See Utah Code 26B-3-301
• Medicaid program: means the state program for medical assistance for persons who are eligible under the state plan adopted pursuant to Title XIX of the federal Social Security Act. See Utah Code 26B-3-101
• Medical assistance: means services furnished or payments made to or on behalf of a member. See Utah Code 26B-3-101
• member: means an individual whom the department has determined to be eligible for assistance under the Medicaid program. See Utah Code 26B-3-101
• Nursing care facility: means the following facilities licensed by the department under 2:

  (i)	skilled nursing facilities;

  (ii)	intermediate care facilities; and

  (iii)

  an intermediate care facility for people with an intellectual disability. See Utah Code 26B-3-301 Nursing care facility program: means the personnel, licenses, services, contracts, and all other requirements that shall be met for a nursing care facility to be eligible for Medicaid certification under this part and division rule. See Utah Code 26B-3-301 Person: means :Utah Code 68-3-12.5 Pharmacist: means a person licensed in this state to engage in the practice of pharmacy under Title 58, Chapter 17b, Pharmacy Practice Act. See Utah Code 26B-3-301 Physical facility: means the buildings or other physical structures where a nursing care facility program is operated. See Utah Code 26B-3-301 Physician: means a person licensed in this state to practice medicine and surgery under Section 58-67-301 or osteopathic medicine under Section 58-68-301. See Utah Code 26B-3-301 Process: means a writ or summons issued in the course of a judicial proceeding. See Utah Code 68-3-12.5 Property: includes both real and personal property. See Utah Code 68-3-12.5 Recipient: means a person who has received medical assistance under the Medicaid program. See Utah Code 26B-3-101 Road: includes :Utah Code 68-3-12.5 Rural county: means a county with a population of less than 50,000, as determined by: (a)  the most recent official census or census estimate of the United States Bureau of the Census; or (b)  the most recent population estimate for the county from the Utah Population Committee, if a population figure for the county is not available under Subsection (20)(a). See Utah Code 26B-3-301 Standards: means the acceptable range of deviation from the criteria that reflects local medical practice and that is tested on the Medicaid recipient database. See Utah Code 26B-3-301 State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5 SURS: means the Surveillance Utilization Review System of the Medicaid program. See Utah Code 26B-3-301 Town: includes , depending on population, a metro township as defined in Section 10-3c-102. See Utah Code 68-3-12.5 underutilization: means the use of a drug in such quantities that the desired therapeutic goal is not achieved. See Utah Code 26B-3-301 United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5 Urban county: means a county that is not a rural county. See Utah Code 26B-3-301 Writing: includes :Utah Code 68-3-12.5