2019 Alaska Statutes
Title 21. Insurance
Chapter 07. Patient Protections Under Health Care Insurance Policies
Sec. 21.07.250. Definitions.
In this chapter,
(1) [Repealed, § 65 ch 41 SLA 2016.]
(2) [Repealed, § 65 ch 41 SLA 2016.]
(3) “emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, that a prudent person who possesses an average knowledge of health and medicine could reasonably expect that the absence of immediate medical attention would result in serious impairment of bodily functions, serious dysfunction of a bodily organ or part, or would place the person's health or, with respect to a pregnant woman, the health of the woman or her unborn child, in serious jeopardy.
(4) “emergency services” means medical care services or items furnished or required to evaluate and treat an emergency medical condition;
(5) “health care insurer” has the meaning given in AS 21.54.500;
(6) “health care provider” means a person licensed in this state or another state of the United States to provide medical care services;
(7) “health insurance” has the meaning given in AS 21.12.050(a);
(8) [Repealed, § 65 ch 41 SLA 2016.]
(9) “medical care” has the meaning given in AS 21.97.900;
(10) “participating health care provider” means a health care provider who has entered into an agreement with a health care insurer to provide services or supplies to a patient covered by a health care insurance policy;
(11) “primary care provider” means a health care provider who provides general medical care services and does not specialize in treating a single injury, illness, or condition or who provides obstetrical, gynecological, or pediatric medical care services;
(12) “provider” means a health care provider;
(13) “religious nonmedical provider” means a person who provides only religious nonmedical treatment or nursing care for an illness or injury;
(14) "utilization review" means a set of techniques designed to monitor the use of, or evaluate the clinical necessity, appropriateness, efficacy, or efficiency of, health care services, procedures, or settings; techniques may include ambulatory review, prospective review, second opinion certification, concurrent review, case management, discharge planning, or retrospective review.
