§16-2L-2. Definitions.

     As used in this article, unless the context requires otherwise:

     (1) "Continuity-of-care" means the clinical practice of a medical professional who provides care to patients in which:

     (A) In addition to episodic or urgent care provided from time to time as needed, preventive care and counseling is provided and a patient's overall health status is monitored even when illness is not present or not in crisis; and

     (B) Without being limited to discrete episodes of care, medical records and care processes are used that track and manage health status over time and allow the medical professional to refer care to, and receive reports from, other medical professionals and other care team members responsible for a patient's care.

     (2) "Federally Qualified Health Center" means an entity as defined in 42 U.S.C. §1396d(l)(2)(B).

     (3) "Medicaid beneficiary" means any person participating, through either a state plan amendment or waiver demonstration, in any Medicaid program administered by the West Virginia Department of Health and Human Resources or its Bureau for Medical Services.

     (4) "Medical home" means a team-based model of care in a patient-centered medical home.

     (5) "Participating provider" means a licensed health care provider who has entered into a contract with a provider sponsored network to provide services to Medicaid enrollees.

     (6) "Participating primary care provider" is a primary care provider who is also a participating provider.

     (7) "Patient-centered medical home" means a health care setting as described in section nine, article twenty-nine-h of this chapter.

     (8) "Primary care provider" means a licensed behavioral health professional or a person licensed as an allopathic or osteopathic physician primarily practicing internal medicine, family or general practice, obstetrics and gynecology, or pediatrics who provides continuity-of-care services to the majority of his or her patients.

     (9) "Provider sponsored network" means an entity licensed by the West Virginia insurance commissioner in accordance with article twenty-five-g, chapter thirty-three of this code.

     (10) "Secretary" means the Secretary of the West Virginia Department of Health and Human Resources.