191—40.1 (514B) Definitions.
“Act” when used in these rules shall mean Iowa Code chapter 514B.
“Complaint” means a written communication expressing a grievance concerning a health maintenance organization.
“Dental care” means care by licensed dentists or by appropriate auxiliary dental personnel working under the supervision of a dentist. It includes the necessary diagnostic, treatment, and preventive services required to maintain proper oral health.
“Governing body” means the persons in which the ultimate responsibility and authority for the conduct of the HMO is vested.
“HMO” means health maintenance organization and shall be abbreviated as HMO in these rules.
“Inpatient hospital care” means inpatient hospital care provided through a licensed hospital on a 24-hour basis.
“Outpatient medical services” means outpatient medical services provided within or outside of a hospital. This shall include, but not be limited to, laboratory and diagnostic X-ray with emphasis directed toward primary care.
“Physician care” means care by a licensed physician or by paramedical or other ancillary health personnel under the direction of the licensed physician. It shall be of sufficient type and amount to adequately provide for the contracted services including emergency care, inpatient hospital care, and outpatient medical services.