42 C.F.R. § 410.140 Definitions.
Title 42 - Public Health
For purposes of this subpart, the following definitions apply: ADA stands for the American Diabetes Association. Approved entity means an individual, physician, or entity accredited by an approved organization as meeting one of the sets of quality standards described in §410.144 and approved by CMS under §410.141(e) to furnish training. Deemed entity means an individual, physician, or entity accredited by an approved organization, but that has not yet been approved by CMS to furnish and receive Medicare payment for the training. Upon being approved by CMS under §410.141(e) to furnish training, CMS refers to this entity as an “approved entity”. Diabetes means diabetes mellitus, a condition of abnormal glucose metabolism diagnosed using the following criteria: A fasting blood sugar greater than or equal to 126 mg/dL on two different occasions; a 2 hour post-glucose challenge greater than or equal to 200 mg/dL on 2 different occasions; or a random glucose test over 200 mg/dL for a person with symptoms of uncontrolled diabetes. NSDSMEP stands for the National Standards for Diabetes Self Management Education Programs. Organization means a national accreditation organization. Rural means an area that meets one of the following conditions: (1) Is not urbanized (as defined by the Bureau of the Census) and that is designated by the chief executive officer of the State, and certified by the Secretary, as an area with a shortage of personal health services. (2) Is designated by the Secretary either as an area with a shortage of personal health services or as a health professional shortage area. (3) Is designated by the Indian Health Service as a health service delivery area as defined in §36.15 of this title. Training means outpatient diabetes self-management training. [65 FR 83148, Dec. 29, 2000, as amended at 68 FR 63261, Nov. 7, 2003]
Title 42: Public Health
PART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS
Subpart H—Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements
§ 410.140 Definitions.
