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Principles of healthcare Reimbursement 4th Edition Ch. 4
Chapter 4 Government-Sponsored Healthcare Programs
Terms in this set (21)
Benefits program administered by the Dept. of Vet. Affairs for the spouse, widow, and or children of a vet who meets specific criteria.
Program that ensures civilian employees of the federal govt. are provided medical, death, and income benefits for work related injuries and illnesses.
INDIAN HEALTH SERVICES (IHS)
An agency within the Dept. of Health and Human Services responsible for upholding the federal government's obligation to promote healthy American Indian and Alaskan native people, communities and cultures.
Part of the Social Security Act, a joint program between state and federal governments to provide healthcare benefits to low-income persons and families.
Federally funded healthcare benefits program for those persons 65 years of age and older as well as for those entitled to Social Security benefits.
(Medicare Part C) Optional managed care plan for Medicare beneficiaries who are entitled to Part A, are enrolled in Part B and live in an area with a plan. Types of plans available are health maintenance organizations, point-of-service plan, preferred provider organization, and provider-sponsored organizations.
Medicare Part A
Covers inpatient hospital services...
Medicare Part B
An optional and supplemental portion of Medicare that provides benefits for physician services, medical services, and medical supplies not covered by Medicare Part A..
Medicare Part C
see Medicare Advantage - Optional care coverage that includes services under Parts A, B, and D and additional services that are not typically covered by Medicare. It requires a premium.
Medicare Part D
Prescription Drug plan created by Medicare Modernization Act of 2003.
Private insurance policy available for Medicare beneficiaries to supplement Medicare Part A and/or Part B...
A joint Medicare/Medicaid venture that allows states to choose a managed care option for providing benefits to the frail, elderly population....
Social Security Act
Federal legislation providing support for state public health activities and healthcare services for mothers and children; amended in 1965 to establish the Medicare and Medicaid program.
A state-federal partnership created by the BBA of 1997 that provides health insurance to children of families whose income level is too high to qualify for Medicaid but too low to purchase healthcare insurance....
Replaced the Aid to Families with Dependent Children program, this program provides states with grant money designated to provide low-income families with assistance.
The healthcare program for active duty and retired members of one of the seven uniformed services administered by the DOD; formerly known as CHAMPUS...
AFFORDABLE CARE ACT (ACA) OF 2012
Improve the quality in Medicare services, Support innovations and the establishment of new payment models, better align Medicare payments with provider cost, Strengthen program integrity within Medicare, put Medicare on a firmer financial footing
An individual who is eligible for benefits from a health plan
CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS)
Responsible for administrating the Medicare program and the federal portion of the Medicaid program
MEDICARE MODERNIZATION ACT (MMA)OF 2003
Most significant legislative change to the Medicare program since its creation; the law created the outpatient prescription drug benefit and provided expanded coverage choices and improved benefits
Medical and income insurance coverage for employees who suffer from a work related injury or illness