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

• Administrator: includes "executor" when the subject matter justifies the use. See Utah Code 68-3-12.5
• Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
• 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.
• 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
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• association: means a corporation or other legal entity, any member of which:
            (2)(a)(i) is an owner of a residential lot located within the jurisdiction of the association, as described in the governing documents; and
            (2)(a)(ii) by virtue of membership or ownership of a residential lot is obligated to pay:

                 (2)(a)(ii)(A) real property taxes;

                 (2)(a)(ii)(B) insurance premiums;

                 (2)(a)(ii)(C) maintenance costs; or

                 (2)(a)(ii)(D) for improvement of real property not owned by the member. See Utah Code 57-8a-102
• Board: means the Drug Utilization Review Board created in Section 26B-3-302. See Utah Code 26B-3-301
• board: means the entity, regardless of name, with primary authority to manage the affairs of the association. See Utah Code 57-8a-102
• Certified program: means a nursing care facility program with Medicaid certification. See Utah Code 26B-3-301
• Charging system: means a device that is:
       (1)(a) used to provide electricity to an electric or hybrid electric vehicle; and
       (1)(b) designed to ensure a safe connection between the electric grid and the vehicle. See Utah Code 57-8a-801
• 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
• Deed: The legal instrument used to transfer title in real property from one person to another.
• Director: means a member of the board of directors. See Utah Code 57-8a-102
• Division: means the Division of Integrated Healthcare within the department, established under Section 26B-3-102. See Utah Code 26B-3-101
• Document: means every instrument in writing, including every conveyance, affecting, purporting to affect, describing, or otherwise concerning any right, title, or interest in real property, except wills and leases for a term not exceeding one year. See Utah Code 57-1-1
• Drug-disease contraindications: means that the therapeutic effect of a drug is adversely altered by the presence of another disease condition. See Utah Code 26B-3-301
• 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
• Equal: means , with respect to biological sex, of the same value. See Utah Code 68-3-12.5
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• 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
• Fraud: Intentional deception resulting in injury to another.
• General electrical contractor: means the same as that term is defined in Section 58-55-102. See Utah Code 57-8a-801
• Governing documents: includes :
            (11)(b)(i) articles of incorporation;
            (11)(b)(ii) bylaws;
            (11)(b)(iii) a plat;
            (11)(b)(iv) a declaration of covenants, conditions, and restrictions; and
            (11)(b)(v) rules of the association. See Utah Code 57-8a-102
• Highway: includes :
       (15)(a) a public bridge;
       (15)(b) a county way;
       (15)(c) a county road;
       (15)(d) a common road; and
       (15)(e) a state road. See Utah Code 68-3-12.5
• Intellectual disability: means a significant, subaverage general intellectual functioning that:
       (16)(a) exists concurrently with deficits in adaptive behavior; and
       (16)(b) is manifested during the developmental period as defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. See 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
• Land: includes :
       (18)(a) land;
       (18)(b) a tenement;
       (18)(c) a hereditament;
       (18)(d) a water right;
       (18)(e) a possessory right; and
       (18)(f) a claim. See Utah Code 68-3-12.5
• 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}
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Lien: A claim against real or personal property in satisfaction of a debt.
• Lot: means :
       (16)(a) a lot, parcel, plot, or other division of land:

            (16)(a)(i) designated for separate ownership or occupancy; and

            (16)(a)(ii)

                 (16)(a)(ii)(A) shown on a recorded subdivision plat; or

                 (16)(a)(ii)(B) the boundaries of which are described in a recorded governing document; or
       (16)(b)

            (16)(b)(i) a unit in a condominium association if the condominium association is a part of a development; or

            (16)(b)(ii) a unit in a real estate cooperative if the real estate cooperative is part of a development. See Utah Code 57-8a-102
• 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
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• Mortgagee: The person to whom property is mortgaged and who has loaned the money.
• Nursing care facility: means the following facilities licensed by the department under Chapter 2, Part 2, Health Care Facility Licensing and Inspection:
            (12)(a)(i) skilled nursing facilities;
            (12)(a)(ii) intermediate care facilities; and
            (12)(a)(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
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Period of administrative control: means the period during which the person who filed the association's governing documents or the person's successor in interest retains authority to:
       (20)(a) appoint or remove members of the association's board of directors; or
       (20)(b) exercise power or authority assigned to the association under the association's governing documents. See Utah Code 57-8a-102
• Person: means :
       (24)(a) an individual;
       (24)(b) an association;
       (24)(c) an institution;
       (24)(d) a corporation;
       (24)(e) a company;
       (24)(f) a trust;
       (24)(g) a limited liability company;
       (24)(h) a partnership;
       (24)(i) a political subdivision;
       (24)(j) a government office, department, division, bureau, or other body of government; and
       (24)(k) any other organization or entity. See 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
• Probate: Proving a will
• 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
• Residential electrical contractor: means the same as that term is defined in Section 58-55-102. See Utah Code 57-8a-801
• Rule: means a policy, guideline, restriction, procedure, or regulation of an association that:
            (25)(a)(i) is not set forth in a contract, easement, article of incorporation, bylaw, or declaration; and
            (25)(a)(ii) governs:

                 (25)(a)(ii)(A) the conduct of persons; or

                 (25)(a)(ii)(B) the use, quality, type, design, or appearance of real property or personal property. See Utah Code 57-8a-102
• Rural county: means a county with a population of less than 50,000, as determined by:
       (20)(a) the most recent official census or census estimate of the United States Bureau of the Census; or
       (20)(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
• Sex offender: means the same as that term is defined in Section Utah Code 57-8a-102
• Solar energy system: means :
       (27)(a) a system that is used to produce electric energy from sunlight; and
       (27)(b) the components of the system described in Subsection (27)(a). See Utah Code 57-8a-102
• 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
• Therapeutic appropriateness: means drug prescribing and dispensing based on rational drug therapy that is consistent with criteria and standards. See Utah Code 26B-3-301
• Therapeutic duplication: means prescribing and dispensing the same drug or two or more drugs from the same therapeutic class where periods of drug administration overlap and where that practice is not medically indicated. See Utah Code 26B-3-301
• Trustee: A person or institution holding and administering property in trust.
• 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 :
       (48)(a) printing;
       (48)(b) handwriting; and
       (48)(c) information stored in an electronic or other medium if the information is retrievable in a perceivable format. See Utah Code 68-3-12.5