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1396k; the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) (Pub. Law 110–343), 2. Federal Regulations: 42 C.F.R. Parts 431, 433, 438, 440, 456, 457 . 3. The Medicaid State Plan and the Section 1115 Demonstration Wavier granted pursuant to § 1115 of the Social Security Act, 42 U.S.C. § 1315 B. Applicable State authority is derived from R.I. Gen. Laws Chapters 40-8, 40-8.4, 40-8.12, and 42-12.3. 2.4 Definitions A. For the purposes of this Rule, the following definitions apply: 1. “Advance practice provider” or “APP” means and includes physician assistants, certified nurse practitioners, psychiatric clinical nurse specialists, and certified nurse midwives. These individuals must maintain compliance with all applicable statutes and regulations and not exceed their scopes of practice. 2. “Appeal” means a formal request by a covered person or provider for reconsideration of a decision, such as a utilization review recommendation, a benefit payment, or administrative action. 3. “Applicant” means a person seeking Medicaid coverage under this Part, in accordance with the provisions established in Rhode Island General Laws and Public Laws. 4. “Care manager” means a nurse or social worker with specialized training in providing care management services. 5. “Complementary alternative medicine” or “CAM” means treatment from a chiropractor, acupuncturist, and/or massage therapist. 6. “Days” means calendar days. 7. “Employer sponsored insurance” or “ESI” means health insurance or a group health plan offered to employees by an employer. This includes plans purchased by small employers through HealthSourceRI. 8. “Enrollee” means a Medicaid member or “beneficiary” who is enrolled in a Medicaid managed care plan. 9. “Executive Office of Health and Human Services" or "EOHHS” means the State agency established in 2006 under the provisions of R.I. Gen. Laws Chapter 42-7.2 within the executive branch of State government and serves as the principal agency for the purposes of managing the