SECTION 23.65. Definitions

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise:

(1) Board--The Texas Higher Education Coordinating Board.

(2) CHIP--The Children's Health Insurance Program, authorized by the Texas Health and Safety Code, Chapter 62.

(3) DSHS--The Texas Department of State Health Services.

(4) Federally Qualified Health Center--Any entity in Texas defined under 42 USC §1396d (l)(2)(B).

(5) Full-time Service--An average of at least 32 hours of direct patient care per week during the service period at the practice site.

(6) HPSAs--Health Professional Shortage Areas (HPSAs) are designated by the U. S. Department of Health and Human Services (HHS) as having shortages of primary medical care, dental or mental health providers and may be geographic (a county or service area), demographic (low income population) or institutional (comprehensive health center, federally qualified health center or other public facility). Designations meet the requirements of Sec. 332 of the Public Health Service Act, 90 Stat. 2270-2272 (42 U.S.C. 254e). Texas HPSAs are recommended for designation by HHS based on analysis of data by DSHS.

(7) Medicaid--The medical assistance program authorized by Chapter 32, Human Resources Code.

(8) NPI--National Provider Identifier; the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA.

(9) Primary Care Physician--Physicians practicing family medicine, family practice, general practice, obstetrics/gynecology, general internal medicine, general pediatrics, combined internal medicine and pediatrics (medicine-pediatrics) in an outpatient setting, psychiatry, or geriatrics. With the exception of psychiatrists and geriatricians, physicians must provide services in an outpatient setting to be considered primary care.

(10) Program--The Physician Education Loan Repayment Program.

(11) Rural HPSA--A HPSA-designated whole county whose population is less than 50,000 or a HPSA-designated facility or population group located in a county whose population is less than 50,000.

(12) Service Period--A period of 12 consecutive months qualifying a physician for loan repayment.

(13) Texas Women's Health Program--The program authorized by Health and Safety Code, §31.002(a)(4)(C) and (H), §31.003, and §31.004, which provides primary health care services, including family planning services and health screenings, at no cost to eligible low-income women; administered by the Texas Health and Human Services Commission.

(14) TMHP--Texas Medicaid and Healthcare Partnership; the entity that administers Texas Medicaid and other state health-care programs on behalf of the Texas Health and Human Services Commission.

(15) TPI--Texas Provider Identifier; the number Managed Care Medicaid Providers must use when filing claims with the Texas Medicaid and Healthcare Partnership (TMHP), for payment of services rendered.

Source Note: The provisions of this §23.65 adopted to be effective November 30, 2009, 34 TexReg 8524; amended to be effective November 20, 2013, 38 TexReg 8196; amended to be effective February 22, 2016, 41 TexReg 1230; transferred effective December 15, 2016, as published in the Texas Register November 25, 2016, 41 TexReg 9341; amended to be effective December 5, 2019, 44 TexReg 7383; amended to be effective November 22, 2020, 45 TexReg 8343