Texas § IN.566.001 - DEFINITIONS

§ IN.566.001. DEFINITIONS

DEFINITIONS. In this chapter: (1) "Assignment" means an agreement in which a supplier agrees to accept the Medicare-approved amount as payment for medical equipment or a medical device or supply. (2) "Durable medical equipment" means medical equipment that: (A) can withstand repeated use; (B) is expected to last at least three years; (C) is primarily and customarily used to serve a medical purpose; (D) is generally not useful in the absence of an illness or injury; and (E) is appropriate for use in the home. (3) "Enrollee" means an individual enrolled in Medicare. (4) "Medicare" means the health benefit coverage provided under the Health Insurance for the Aged Act (42 U.S.C. Section 1395 et seq.). (5) "Nonparticipating supplier" means an entity or person who: (A) provides Medicare-covered durable medical equipment, orthotic devices or supplies, or prosthetic devices or supplies to Medicare enrollees; and (B) is not enrolled in Medicare as a participating supplier. (6) "Orthotic device or supply" means: (A) a custom-fitted or custom-fabricated medical device designed to correct a deformity, improve function, or relieve symptoms of a disease; or (B) a medical supply related to a device described by Paragraph (A). (7) "Prosthetic device or supply" means: (A) an artificial medical device designed to replace all or part of a limb or internal organ; or (B) a medical supply related to a device described by Paragraph (A). Added by Acts 2025, 89th Leg., R.S., Ch. 1003 (S.B. 1330 ), Sec. 1, eff. September 1, 2025. SUBCHAPTER B. REGULATION OF CERTAIN BILLING PRACTICES