[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR491.2]



[Page 970-971]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 491_CERTIFICATION OF CERTAIN HEALTH FACILITIES--Table of Contents

 

Subpart A_Rural Health Clinics: Conditions for Certification; and FQHCs 

                         Conditions for Coverage

 

Sec.  491.2  Definitions.



    As used in this subpart, unless the context indicates otherwise:

    Direct services means services provided by the clinic's staff.

    FQHC means an entity as defined in Sec.  405.2401(b).

    Nurse practitioner means a registered professional nurse who is 

currently licensed to practice in the State, who



[[Page 971]]



meets the State's requirements governing the qualifications of nurse 

practitioners, and who meets one of the following conditions:

    (1) Is currently certified as a primary care nurse practitioner by 

the American Nurses' Association or by the National Board of Pediatric 

Nurse Practitioners and Associates; or

    (2) Has satisfactorily completed a formal 1 academic year 

educational program that:

    (i) Prepares registered nurses to perform an expanded role in the 

delivery of primary care;

    (ii) Includes at least 4 months (in the aggregate) of classroom 

instruction and a component of supervised clinical practice; and

    (iii) Awards a degree, diploma, or certificate to persons who 

successfully complete the program; or

    (3) Has successfully completed a formal educational program (for 

preparing registered nurses to perform an expanded role in the delivery 

of primary care) that does not meet the requirements of paragraph (2) of 

this definition, and has been performing an expanded role in the 

delivery of primary care for a total of 12 months during the 18-month 

period immediately preceding the effective date of this subpart.

    Physician means a doctor of medicine or osteopathy legally 

authorized to practice medicine or surgery in the State.

    Physician assistant means a person who meets the applicable State 

requirements governing the qualifications for assistants to primary care 

physicians, and who meets at least one of the following conditions:

    (1) Is currently certified by the National Commission on 

Certification of Physician Assistants to assist primary care physicians; 

or

    (2) Has satisfactorily completed a program for preparing physician's 

assistants that:

    (i) Was at least 1 academic year in length;

    (ii) Consisted of supervised clinical practice and at least 4 months 

(in the aggregate) of classroom instruction directed toward preparing 

students to deliver health care; and

    (iii) Was accredited by the American Medical Association's Committee 

on Allied Health Education and Accreditation; or

    (3) Has satisfactorily completed a formal educational program (for 

preparing physician assistants) that does not meet the requirements of 

paragraph (2) of this definition and assisted primary care physicians 

for a total of 12 months during the 18-month period that ended on 

December 31, 1986.

    Rural area means an area that is not delineated as an urbanized area 

by the Bureau of the Census.

    Rural health clinic or clinic means a clinic that is located in a 

rural area designated as a shortage area, is not a rehabilitation agency 

or a facility primarily for the care and treatment of mental diseases, 

and meets all other requirements of this subpart.

    Shortage area means a defined geographic area designated by the 

Department as having either a shortage of personal health services 

(under section 1302(7) of the Public Health Service Act) or a shortage 

of primary medical care manpower (under section 332 of that Act).

    Secretary means the Secretary of Health and Human Services, or any 

official to whom he has delegated the pertinent authority.



[71 FR 55345, Sept. 22, 2006]