Terms Used In Nebraska Statutes > Out-of-Network Emergency Medical Care Act

• Action: shall include any proceeding in any court of this state. See Nebraska Statutes 49-801
• Attorney: shall mean attorney at law. See Nebraska Statutes 49-801
• Company: shall include any corporation, partnership, limited liability company, joint-stock company, joint venture, or association. See Nebraska Statutes 49-801
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Contract: A legal written agreement that becomes binding when signed.
• Conviction: A judgement of guilt against a criminal defendant.
• 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.
• Covered person: means a person on whose behalf an insurer is obligated to pay health care expense benefits or provide health care services. See Nebraska Statutes 44-6836
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Department: shall mean the Department of Insurance. See Nebraska Statutes 44-103
• Emergency medical condition: means a medical or behavioral condition, the onset of which is sudden, that manifests itself by symptoms of sufficient severity, including, but not limited to, severe pain, that a prudent layperson, possessing an average knowledge of medicine and health, could reasonably expect the absence of immediate medical attention to result in (1) placing the health of the person afflicted with such condition in serious jeopardy or, in the case of a behavioral condition, placing the health of such persons or others in serious jeopardy, (2) serious impairment to such person's bodily functions, (3) serious impairment of any bodily organ or part of such person, or (4) serious disfigurement of such person. See Nebraska Statutes 44-6837
• Emergency services: means health care services medically necessary to screen and stabilize a covered person in connection with an emergency medical condition. See Nebraska Statutes 44-6838
• Health benefits plan: means a benefits plan which pays or provides hospital and medical expense benefits for covered services and is delivered or issued for delivery in this state by or through an insurer. See Nebraska Statutes 44-6839
• Health benefits plan does not: include the medical assistance program, medicare, medicare advantage, accident-only, credit, disability, or long-term care coverage, TRICARE supplement coverage, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance, personal injury protection insurance, and hospital confinement indemnity coverage. See Nebraska Statutes 44-6839
• Health care facility: means a general acute hospital, satellite emergency department, or ambulatory surgical center licensed pursuant to the Health Care Facility Licensure Act. See Nebraska Statutes 44-6840
• Health care professional: means an individual who is credentialed pursuant to the Uniform Credentialing Act, who is acting within the scope of his or her credential, and who provides a covered service defined by the health benefits plan. See Nebraska Statutes 44-6841
• Health care provider: means a health care professional or health care facility. See Nebraska Statutes 44-6842
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• Insurer: means an entity that contracts to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefits plan, including (1) any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or surgical expense-incurred policy, except for a policy that provides coverage for a specified disease or other limited-benefit coverage, and (2) any self-funded employee benefit plan to the extent not preempted by federal law. See Nebraska Statutes 44-6843
• 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.
• 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}
• Maintenance: means the act, operation, or continuous process of repair, reconstruction, or preservation of the whole or any part of any highway, including surface, shoulders, roadsides, traffic control devices, structures, waterways, and drainage facilities, for the purpose of keeping it at or near or improving upon its original standard of usefulness and safety. See Nebraska Statutes 39-101
• Medical assistance program: means the medical assistance program established pursuant to the Medical Assistance Act. See Nebraska Statutes 44-6844
• Medically necessary: means a health care service that a health care provider, exercising his or her prudent clinical judgment, would provide to a covered person for the purpose of evaluating, diagnosing, or treating an illness, an injury, or a disease, or its symptoms, and that is in accordance with the generally accepted standards of medical practice. See Nebraska Statutes 44-6845
• Person: shall include bodies politic and corporate, societies, communities, the public generally, individuals, partnerships, limited liability companies, joint-stock companies, and associations. See Nebraska Statutes 49-801
• Personal property: All property that is not real property.
• Process: shall mean a summons, subpoena, or notice to appear issued out of a court in the course of judicial proceedings. See Nebraska Statutes 49-801
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• Right-of-way: means the right of one vehicle or pedestrian to proceed in a lawful manner in preference to another vehicle or pedestrian approaching under such circumstances of direction, speed, and proximity as to give rise to danger of collision unless one grants precedence to the other. See Nebraska Statutes 39-101
• Roadway: means that portion of a highway improved, designed, or ordinarily used for vehicular travel, exclusive of the berm or shoulder. See Nebraska Statutes 39-101
• Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
• Sidewalk: means that portion of a highway between the curb lines, or the lateral lines of a roadway, and the adjacent property lines, intended for use by pedestrians. See Nebraska Statutes 39-101
• State: when applied to different states of the United States shall be construed to extend to and include the District of Columbia and the several territories organized by Congress. See Nebraska Statutes 49-801
• Traffic: means pedestrians, ridden or herded animals, and vehicles and other conveyances either singly or together while using any highway for purposes of travel. See Nebraska Statutes 39-101
• TRICARE: means a health care program of the United States Department of Defense Military Health System. See Nebraska Statutes 44-6846
• United States: shall include territories, outlying possessions, and the District of Columbia. See Nebraska Statutes 49-801
• Year: shall mean calendar year. See Nebraska Statutes 49-801