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Medicaid

CMS

Centers for Medicaid and Medicare Services

DEFRA

Deficit Reduction Act

EPSDT

early, periodic, screening, diagnosis, and treatment

FPL

Federal Paverty Level

HMO

Health Maintenance Organization

MCD

Medicaid

MCHP

Maternal and Child Health Programs

MCO

managed care organization

MQMB

Medical Qualified Medicare Beneficiary

MN

medically needy

OBRA

Omnibus Budget Reconciliation Act

OOY

over-one-year claims

POS

point of service machine

QI

Quality Individuals program

QMB

qualified Medicare beneficiary

RA

remittance advice

SCHIP

State Children's Health Care Program

SLMB

Specified Low-Income Medicare Beneficiary

SSI

Supplemental Security Income

TANF

Temporary Assistance to Needy Families

TEFRA

Tax Equity and Fiscal Responsibility Act

set up the public assistance programs

The Social Security Act of 1935

medical expenses of the needy unemployed

The Federal Emergency Relief Administration made funds available to pay for

The Medicaid program was a direct result of

a law passed by Congress in 1950.

welfare agency directly to the physician

In the Medicaid program, Congress authorized vendor payments for medical care, which are payments from the

The medically needy aged

require help in meeting costs of medical care

DEFRA and CHAP were responsible for

expanding Medicaid eligibility requirements

Medicaid is administered by the

state government with partial federal funding

CMS

The federal aspects of Medicaid are the responsibility of the

The Omnibus Budget Reconciliation Act

provided assistance for the aged and disabled who are receiving Medicare and whose incomes are below the poverty level.

the Medicaid-allowed amount

If a physician accepts Medicaid patients, the physician must accept

EPSDT

The Medicaid service for prevention, early detection, and treatment for welfare children is known as

managed care programs

To control escalating health care costs by curbing unnecessary emergency department visits and emphasizing preventive care, Medicaid reform has involved

120 days

The time limit to appeal a claim varies from state to state, but it is usually

categorically needy
medically needy

The two Medicaid eligibility classifications are the

95 days

time limit for filing medicaid only claims

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