Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 8238 (December 30, 2023).

55 Pa. Code § 1229.2. Definitions.

§ 1229.2. Definitions.

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

   Health Maintenance Organization (HMO)—A legal entity determined by the Assistant Secretary for Health, Department of Health and Human Services, to be organized and operated in the manner prescribed in section 1301(c) of the Social Security Act (42 U.S.C.A. §  300e(c)) and which provides, in the manner prescribed by section 1301(b) of the Social Security Act (42 U.S.C.A. §  300e(b)) at least the following health services to its eligible enrollees:

     (i)   Inpatient hospital services.

     (ii)   Outpatient services.

     (iii)   Laboratory and X-ray services.

     (iv)   Family planning services and supplies.

     (v)   Physician services.

     (vi)   Home health services for individuals entitled to those services under the Medicaid State Plan.

Source

   The provisions of this §  1229.2 adopted October 31, 1980, effective November 1, 1980, 10 Pa.B. 4255.



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