WAC 246-130-010   What definitions does the early intervention program use?  The following words and phrases have the following meaning in chapter 246-130 WAC:

     (1) "AIDS" means acquired immunodeficiency syndrome.

     (2) "Applicant" means a person applying for early intervention program services.

     (3) "Benefits manager" means:

     (a) The pharmacy benefits manager contracted with the department to provide prescription drug claim processing and formulary management services; or

     (b) The insurance benefits manager contracted with the department to provide insurance premium assistance through the HIV insurance program and the medicare premium assistance program.

     (4) "Client" means a person who the department determines is currently eligible for early intervention program services.

     (5) "Department" means the Washington state department of health.

     (6) "Early intervention program services" means medically necessary treatment and services that reduce the rate of progression of HIV infection and HIV transmission. This includes behavioral risk reduction interventions. See WAC 246-130-020 for details.

     (7) "Federal poverty level" means the official income level for poverty released by the federal government each year in February.

     (8) "Formulary" means the list of prescription drugs that the early intervention program will pay for. To obtain a copy of that list, see WAC 246-130-090.

     (9) "HIV" means human immunodeficiency virus as defined in RCW 70.24.017(7).

     (10) "HIV insurance program" means the program that provides health insurance coverage for individuals with HIV who are not eligible for medical assistance programs from the department of social and health services. Medical assistance program is defined in RCW 74.9.010(8). Individuals must meet the eligibility requirements established by the department.

     (11) "Medicare premium assistance" means the program that pays premiums, copayments and deductibles for department clients receiving medicare and enrolled in the prescription drug program.

     (12) "Provider" means a health care professional contracted by the department to supply medical, dental, or laboratory services to a client.

     (13) "Schedule of services" means the department's list of medical, dental, and laboratory services covered by its early intervention program. To obtain a copy of that list, see WAC 246-130-090.

     (14) "Standard of care" means treatment for HIV that is commonly accepted by the local medical community.

     (15) "Steering committee" means the department's early intervention steering committee. This advisory committee serves at the pleasure of the department secretary in accordance with RCW 43.70.040(2). The committee consists of Washington state residents living with HIV, HIV medical experts, and representatives from community organizations. The steering committee advises the department on its early intervention program.



[Statutory Authority: RCW 43.70.670. 05-23-100, § 246-130-010, filed 11/17/05, effective 12/18/05. Statutory Authority: RCW 43.70.040 and 43.70.120. 00-19-117, § 246-130-010, filed 9/20/00, effective 10/21/00; 95-23-018, § 246-130-010, filed 11/7/95, effective 12/8/95. Statutory Authority: RCW 43.70.120. 92-02-018 (Order 224), § 246-130-010, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-130-010, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.70.120. 90-17-087 (Order 071), § 248-168-015, filed 8/17/90, effective 9/17/90.]