Sec.17b-34-2. Definitions

Unless otherwise defined in this section, the definitions provided in 42 CFR 495.4 and 42 CFR 495.302 apply to sections 17b-34-1 to 17b-34-9, inclusive, of the Regulations of Connecticut State Agencies. As used in sections 17b-34-1 to 17b-34-9, inclusive, of the Regulations of Connecticut State Agencies:

(1) “Adopt, implement or upgrade” or “AIU” means one or more of the following:

(A) Acquire, purchase or install a certified EHR system;

(B) install or commence use of a certified EHR system and have started one of the following: A training program for the certified EHR system; data entry of patient demographic and administrative data into the EHR; or establishment of data exchange agreements and a relationship between the provider’s certified EHR system and health information exchanges or other providers including, but not limited to, laboratories and pharmacies;

(C) expand available functionality of certified EHR technology capable of meeting meaningful use requirements at a practice site, including staffing, maintenance and training; or

(D) upgrade from existing EHR technology to certified EHR technology, including, but not limited to, upgrades to the addition of clinical decision support, e-prescribing functionality and computerized physician order entry;

(2) “Certified electronic health record” or “certified EHR” means EHR technology certified in accordance with the EHR certification criteria of the Office of the National Coordinator for Health Information Technology;

(3) “CMS” means the Centers for Medicare and Medicaid Services;

(4) “Commissioner” means the Commissioner of Social Services or the commissioner’s designee;

(5) “Department” means the Department of Social Services or its agent;

(6) “Electronic health record” or “EHR” means a systematic collection of electronic health information on individual patients in a digital format that includes a range of data in comprehensive or summary form, such as: Demographics; medical history; medication; medication allergies; immunization status; laboratory test results; radiology images; vital signs; and personal statistics such as age, weight and billing information;

(7) “Electronic Health Record Incentive Program” or “EHR Incentive Program” means the incentive program established pursuant to section 17b-34 of the Connecticut General Statues and authorized by 42 USC 1396b(a)(3)(F) and 42 USC 1396b(t), that enables providers to receive funding from the department to promote AIU and meaningful use;

(8) “Eligible hospital” means a children’s hospital or an acute care hospital, as such terms are defined in 42 CFR 495.302;

(9) “Eligible professional” or “EP” means a professional as described in 42 CFR 495.304(b) to 42 CFR 495.304(d), inclusive;

(10) “Hospital-based EP” means an EP who furnishes ninety percent or more of the EP’s covered professional services in a hospital setting as measured by data in the calendar year preceding the payment year;

(11) “Hospital setting” means a site of service that is identified by the codes used in Health Insurance Portability and Accountability Act standard transactions as an inpatient hospital or emergency room setting;

(12) “Meaningful use” means use of certified EHR in a meaningful manner, including, but not limited to: E-prescribing; the use of certified EHR technology for electronic exchange of health information to improve quality of health care; or the use of certified EHR technology to submit clinical quality and other measures;

(13) “Medicaid” means the program operated by the department pursuant to section 17b-261 of the Connecticut General Statutes and authorized by Title XIX of the Social Security Act;

(14) “Patient volume” means the minimum participation threshold that is estimated using the methodology in 42 CFR 495.306(c);

(15) “Pediatrician” means a physician whose practice is comprised of at least ninety percent of patients age 18 and under, and who:

(A) Holds board certification by the American Board of Pediatrics in pediatrics or a pediatric subspecialty;

(B) in the opinion of the department has training or experience comparable to that required for board certification by the American Board of Pediatrics in pediatrics or a pediatric subspecialty;

(C) holds board certification by the American Board of Medical Specialties in any specialty recognized by such board and serves a pediatric patient population; or

(D) in the opinion of the department provides what is generally accepted to be specialty care to a pediatric patient population;

(16) “Physician” means a person licensed pursuant to section 20-13 of the Connecticut General Statutes; and

(17) “Provider” means a provider enrolled in Medicaid.

(Effective January 13, 2013)