Page 22

UNOFFICIAL 1700.1-22 (B) There is a supporting entry in the case record that the individual has died; or (C) There is a supporting entry in the case record that the individual cannot be located. “Eligibility determination” means an approval or denial of eligibility for medical assistance as well as a redetermination or termination of eligibility for medical assistance. “Emergency” means a situation where a person's life or health is in imminent danger as the result of illness or injury and specialized services must be provided without delay. “Emergency medical condition” means the sudden onset of a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain, psychiatric disturbances and/or symptoms substance abuse) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of emergency services or immediate medical attention to result in: (1) Placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; (2) Serious impairment to body functions; (3) Serious dysfunction of any bodily organ or part; (4) Serious harm to self or others due to an alcohol or drug abuse emergency; (5) Injury to self or bodily harm to others; or (6) With respect to a pregnant woman who is having contractions: (A) That there is inadequate time to effect a safe transfer to another hospital before delivery; or (B) That transfer may pose a threat to the health or safety of the woman or her unborn child. “Emergency services” means covered inpatient and outpatient services that are needed to evaluate or