Acronym Definition(s) Note: These acronyms may have other definitions, but those listed are intended to be HHS/CMS oriented

Size: px
Start display at page:

Download "Acronym Definition(s) Note: These acronyms may have other definitions, but those listed are intended to be HHS/CMS oriented"

Transcription

1 A AAC AAPC Actual Acquisition Cost (the net cost of a drug paid by a pharmacy) Adjusted Average Per Capita Cost (amount of funding a Medicare managed care plan receives from CMS to cover its costs) ACA Patient Protection and Affordable Care Act (of 2010) ACF ACO ADA ADL AHLAT AHRQ ANSI APC APD APG APHSA Administration for Children and Families Accountable Care Organization 1. Americans with Disabilities Act 2. American Dental Association Activities of Daily Living (activities performed by individuals without assistance) Armed Forces Health Longitudinal Technology Application (Department of Defense (DoD) electronic health record (EHR) system) Agency for Healthcare Research and Quality American National Standards Institute Ambulatory Payment Classification Advance Planning Document Ambulatory Patient Group American Public Human Services Association ARRA American Recovery and Reinvestment Act of 2009 ASC X12 ASCII Accredited Standards Committee (chartered by the American National Standards Institute to develop electronic data interchange (EDI) standards) American Standard Code for Information Interchange B BAA BENDEX BI BPM Business Associate Agreement (mandatory under the Health Insurance Portability and Accountability Act (HIPAA)) Beneficiary and Earnings Data Exchange 1. Background Investigation 2. Benefits Integrity 3. Business Intelligence Business Process Management or Model C CAP CAQH CBA CCF 1. Corrective Action Plan 2. Cost Allocation Plan Council for Affordable Quality Healthcare Cost/Benefit Analysis Center for Children and Families

2 CCHIT CCI CCIIO CDC CDM CESA CFR CHIP Certification Commission for Healthcare Information Technology Correct Coding Initiative (a large set of procedure code edits adopted by Medicaid) Center for Consumer Information and Insurance Oversight Centers for Disease Control and Prevention 1. Charge Description Master (Hospital Files) 2. Conceptual Data Model 3. Canonical Data Model Cooperative Education Service Agency (Wisconsin only) Code of Federal Regulations 1. Children's Health Insurance Program 2. Catastrophic Health Care Program CHIPRA Children's Health Insurance Program Reauthorization Act of 2009 CLIA Clinical Laboratory Improvement Act of 1965 (with amendments in 1988) CM CMCS CMHC CMI CMMI CMS COB COBA COLA CORE COS COTS CPHA CPT CRF CRN CSP CRNP 1. Clinical Management 2. Configuration Management 1. Center for Medicaid and Children's Health Insurance Program (CHIP) Services 2. Center for Medicaid, CHIP, and Survey and Certification Community Mental Health Center Case Mix Indicator (a relative value assigned to a diagnosis-related group of patients in a medical care environment) Capability Maturity Model Integration Centers for Medicare and Medicaid Services Coordination of Benefits Coordination of Benefits Agreement Cost-of-Living Adjustment Committee on Operating Rules for Information Exchange Category of Service (assigned codes to identify approved services) Commercial Off-the-Shelf (software) Commission on Professional and Hospital Activities Current Procedural Terminology 1. Community Resident Facility 2. Change Request Form Claim Reference Number 1. Customer Service Plan 2. Customer Service Program Certified Registered Nurse Practitioner

3 CSR 1. Customer Service Representative 2. Customer Service Record D DAW DBMS DCN DDI DEA DEERS DESI DGB DHS DHHS DME DRG DSD DSH DSMO DSS DUR DW Dispense as Written Database Management System Document Control Number 1. Design, Development, and Implementation 2. Design, Develop, and Implement Drug Enforcement Administration (or Agency) Defense Enrollment Eligibility Reporting System (Department of Defense) Drug Efficacy Study Implementation Data Governance Board 1. Department of Human Services 2. U.S. Department of Homeland Security U.S. Department of Health and Human Services 1. Durable Medical Equipment 2. Distributed Management Environment Diagnosis Related Group Detailed System Design Disproportionate Share Hospital Designated Standards Maintenance Organization Decision Support System Drug Utilization Review Data Warehouse E EA EAC ECS EDH Interchange EDI EFT EHR 1. Enterprise Architecture 2. Emergency Assistance 1. Estimated Acquisition Cost (for drugs) 2. Estimate at Completion Electronic Claim Submission (insurance) Enterprise Data Hub Electronic Data Interchange Electronic Funds Transfer Electronic Health Record

4 EITA EMC EMR EOMB EOP ephi EPSDT EQRO ERP ESB ETL EVS Exchange Information Technology Architecture Electronic Media Claims (same as Electronic Claim Submission) Electronic Medical Record 1. Explanation Of Medical Benefits 2. Explanation of Medicare Benefits 3. Executive Office of Management and Budget Explanation of Payment Electronic Protected Health Information Early and Periodic Screening, Diagnosis, and Treatment (Program or Services) External Quality Review Organization (a peer review organization-like entity) 1. Estate Recovery Program (Medicaid collection against the estate of deceased recipients 55 or older when assistance was issued) 2. Enterprise Resource Planning Enterprise Service Bus (software architecture model used for designing and implementing communication between mutually interacting software) Extract, Transform, and Load Eligibility Verification System F FA FEPS FFE FFP FHA FI FMAC FMAP FPL FPW FQHC FWA 1. Fiscal Agent 2. Fraud and Abuse Federal Exchange Program System Federally-Facilitated Exchange Federal Financial Participation 1. Federal Health Architecture 2. Federal Housing Administration 3. Federal Highway Administration Fiscal Intermediary Federal Maximum Allowable Cost 1. Federal Medical Assistance Percentage 2. Federal Medical Assistance Payments Federal Poverty Level Family Planning Waiver (Program or Plan) Federally Qualified Health Center Fraud, Waste, and Abuse G GAMC General Assistance Medical Care

5 GPRA Government Performance Results Act (of 1993) H HCBS HCBW HCPCS HDX HEDIS HHS HIE HIMSS Home and Community Based Service Home and Community Based Waiver (Program) Healthcare Common Procedure Coding System Healthcare Data Exchange 1. Health Employer Data and Information Set 2. Healthcare Effectiveness Data and Information Set (HEDIS ) 3. Healthplan Employer Data and Information Sets U.S. Department of Health and Human Services Health Information Exchange 1. Health Information and Management Systems Society 2. Healthcare Information and Management Systems Society (American Hospital Association) HIPAA Health Insurance Portability and Accountability Act of 1996 HIPP HIPPS HISPC HIT HITECH HITSP HIX HL7 HMO Health Insurance Premium Payment (Program) Health Insurance Prospective Payment System (a CMS payment code system) Health Information Security and Privacy Collaboration Health Information Technology Healthcare Information Technology for Economic and Clinical Health Act Healthcare Information Technology Standards Panel Health Insurance Exchange Health Level Seven (a set of international standards for transfer of clinical and administrative data between hospital information systems (Global authority in standards for interoperability of Health Information Technology)) Health Maintenance Organization I IAPD IBP ICD-10 Implementation Advance Planning Document 1. Industry Best Practices 2. Implementing Best Practices International Statistical Classification of Disease and Related Health Problems (10th revision) IC/MR Intermediate Care Facility for the Mentally Retarded (reclassified, based on Rosa s Law in 2010) ICF/IID Intermediate Care Facility for Individuals with Intellectual Disabilities

6 ICN IDIQ IE&E IEEE IES IHS IMD ISO ISP ITIL IV&V 1. Internal Control Number (used to uniquely identify MMIS health care claims) 2. In-house Claim Number 3. Inquiry Control Number 4. Intermediary Control Number 5. Inventory Control Number 1. Indefinite Delivery/Indefinite Quantity 2. Indefinite Duration, Indefinite Quantity Integrated Eligibility and Enrollment( a mandate of Patient Protection and Affordable Care Act of 2010 (PPACA)) Institute of Electrical and Electronics Engineers Integrated Eligibility System Indian Health Service 1. Institution for Mental Diseases 2. Institute for Mental Disease International Organization for Standardization Individual Service Plan Information Technology Infrastructure Library Independent Verification and Validation J JAD JAR Joint Application Design Joint Application Requirements L LDM LTC LTCH Logical Data Model Long-Term Care Long-Term Care Hospital M M&M MARS MARX MBE MBES MCH Medicare and Medicaid 1. Management and Administrative Reporting System 2. Management and Administrative Reporting Subsystem 3. Medicare Accounts Receivable System Medicare Advantage and Prescription Drug System 1. Minority Business Enterprise 2. Medicaid Budget and Expenditures Medicaid Budget and Expenditure System Maternal and Child Health

7 MCO Managed Care Organization MECT Medicaid Enterprise Certification Toolkit MEQC Medicaid Eligibility Quality Control (System) MESC Medicaid Enterprise Systems Conference (replaced Medicaid Management Information Systems (MMIS) Conference in 2012) MFCU Medicaid Fraud Control Unit MITA Medicaid Information Technology Architecture MMA Medicare Modernization Act of 1999 (updated in 2003) MMIS Medicaid Management Information System MOTS Modified Off-the-Shelf N NAMPI NASCIO NASMD NCPDP NDC NHIN NHIS NIEM NIST NMEH NPDB NPI NPI Enumerator NPP NPPES NwHIN National Association for Medicaid Program Integrity (replaces NASO, the National Association of Surveillance and Utilization Review Subsystem (SURS) Officials) National Association of State Chief Information Officers National Association of State Medicaid Directors National Council for Prescription Drug Programs National Drug Code Nationwide Health Information Network (now referred to as the ehealth Exchange) 1. National Health Information System 2. National Health Interview Survey National Information Exchange Model National Institute of Standards and Technology National Medicaid EDI HIPAA Workgroup National Practitioner Data Bank National Provider Identifier CMS contractor responsible for assisting health care providers in applying for their NPIs and updating their information in the National Provider and Plan Enumeration System 1. Notices of Privacy Practices 2. Non-Physician Practitioner National Provider and Plan Enumeration System Nationwide Health Information Network (now referred to as the ehealth Exchange) O OASIS OBRA OIS Outcome and Assessment Information Set Omnibus Budget Reconciliation Act Office of Information Services (of CMS)

8 OLAP ONC OPPS OSCAR Online Analytical Processing Office of the National Coordinator for Health Information Technology Outpatient Prospective Payment System 1. Online Survey Certification and Reporting (System) 2. Office of Standards and Certification Automated Retrieval (System) P P4P PA PACE PAL PAM PAPD PARIS PASARR PBM PCCM PCP PCPCM PCS PDA PE PECOS Pay for Performance 1. Prior Authorization 2. Privacy Act of Project Assessment 1. Program of All-Inclusive Care for the Elderly 2. Pharmaceutical Assistance Contract for the Elderly (Program) 3. Planning, Assigning, Controlling, and Evaluating System Provider Audit List 1. Payment Accuracy Measurement 2. Priority Audit Memorandum 3. Project Administration Manual Planning Advance Planning Document Public Assistance Reporting Information System Preadmission Screening and Resident Review Pharmacy Benefit Management or Manager Primary Care Case Management or Manager Primary Care Physician or Provider Primary Care Physician Case Manager Procedure Coding System 1. Personal Digital Assistant 2. Premium Due Amount 1. Presumptive Eligibility 2. Practice Expense 3. Performance Evaluation 4. Post Entitlement 5. Program Evaluation Provider Enrollment, Chain and Ownership System PERM Payment Error Rate Measurement (Act of amended in 2010) Payment Error Reduction and Measurement PHDSC Public Health Data Standards Consortium

9 PHI PHIN PHP PHR PIP PKI PMBOK PMI PMO PMP PPACA PPO PRO PSTG 1. Protected Health Information 2. Private Health Insurance Public Health Information Network (national initiative, developed by the CDC) 1. Prepaid Health Plan 2. Partial Hospitalization Program 1. Personal Health Record 2. Professional Health Research 1. Periodic Interim Payment 2. Performance Improvement Plan 3. Physician Incentive Plan 4. Productivity Improvement Program Public Key Infrastructure Project Management Body of Knowledge Project Management Institute Project Management Office Project Management Professional Patient Protection and Affordable Care Act (of 2010) (commonly called the Affordable Care Act (ACA)) Preferred Provider Organization Peer Review Organization (renamed Quality Improvement Organization) Private Sector Technology Group Q QA QAE QC QDWI QIO QM QMB 1. Quality Assurance 2. Quality Assessment Quality Assurance Evaluator Quality Control Qualified Disabled and Working Individual Quality Improvement Organization (current term for Peer Review Organization) Quality Management Qualified Medicare Beneficiary R RA RAC RAMS Risk Assessment Recovery Audit Contractor (Program) Requirements Analysis Management System Reliability, Availability, Maintainability, Safety (Analysis)

10 REC REOMB RHIO ROSI RUG Regional Extension Center Recipient Explanation of Medical Benefits Regional Health Information Organization Reconciliation of State Invoice Resource Utilization Group S SACWIS SAMHSA SBE SCHIP SDLC SDO SDW SDX SEI SLA SMHP SME SMM SNAP SNF SNIP SOA SOBRA SOLQ SOW SQL SS-A SSA SSOP S-TAG Statewide Automated Child Welfare Information System Substance Abuse and Mental Health Services Administration State-based Exchange State Children's Health Insurance Program (currently named Children s Health Insurance Program) 1. System Development Life Cycle 2. Software Development Life Cycle Standards Development Organization Shared Data Warehouse State Data Exchange Software Engineering Institute Service Level Agreement State Medicaid Health Information Technology (HIT) Plan Subject Matter Expert State Medicaid Manual Supplemental Nutrition Assistance Program Skilled Nursing Facility Strategic National Implementation Process Service-Oriented Architecture Sixth Omnibus Budget Reconciliation Act State Online Query (the Social Security Administration s system to authenticate access to individual social security records) 1. Scope of Work 2. Statement of Work Structured Query Language State Self-Assessment (a tool or report that is a component of MITA) Social Security Administration Second Surgical Opinion Program State Systems Technical Advisory Group

11 STAG SUR SURS System Technical Advisory Group Surveillance and Utilization Review Surveillance and Utilization Review Subsystem T TAG TANF TPA TPL Technical Advisory Group Temporary Assistance for Needy Families 1. Third Party Administrator 2. Trading Partner Agreement (required under section 201(a)(5) of the HIPAA) Third-Party Liability V VA U.S. Department of Veterans Affairs W WBE WBS WEDI WIC Woman-Owned Business Enterprise Work Breakdown Structure or Schedule Workgroup for Electronic Data Interchange Women, Infants, and Children (federal program to ensure proper nutrition (special supplemental nutrition program)) X X12 American National Standards Institute (ANSI) (committee responsible for EDI standards)

HIPAA: AN OVERVIEW September 2013

HIPAA: AN OVERVIEW September 2013 HIPAA: AN OVERVIEW September 2013 Introduction The Health Insurance Portability and Accountability Act of 1996, known as HIPAA, was enacted on August 21, 1996. The overall goal was to simplify and streamline

More information

Department of Social Services. South Dakota Medicaid Division of Medical Services (MS)

Department of Social Services. South Dakota Medicaid Division of Medical Services (MS) Department of Social Services South Dakota Medicaid Division of Medical Services (MS) Overview What is Medicaid? Who We Serve Services Provided Medicaid Budget South Dakota Medicaid: Medicaid is the nation

More information

Quarterly Medicaid Statement of Expenditures For the Medical Assistance Program

Quarterly Medicaid Statement of Expenditures For the Medical Assistance Program Quarterly Medicaid Statement of Expenditures For the Medical Assistance Program CMS 64 Summary Sheet Net Expenditures Reported In This Period (Sum of Items 6, 7 and 8 Less 9 and 10) I certify that: Certification

More information

Health Information Technology (IT) Simplified

Health Information Technology (IT) Simplified Health Information Technology (IT) Simplified A glossary of all things Health IT Accountable Care Organizations (ACO) - A group of health care providers who give coordinated care, chronic disease management,

More information

11/7/2013 HARMONIZING & STANDARDIZING BEHAVIORAL HEALTH CLAIMS, DATA COLLECTION AND REPORTING REQUIREMENTS. Xpio Health. MITA 3.

11/7/2013 HARMONIZING & STANDARDIZING BEHAVIORAL HEALTH CLAIMS, DATA COLLECTION AND REPORTING REQUIREMENTS. Xpio Health. MITA 3. HARMONIZING & STANDARDIZING BEHAVIORAL HEALTH CLAIMS, DATA COLLECTION AND REPORTING REQUIREMENTS Xpio Health Behavioral Healthcare and Medicaid System specific technology consulting firm Meaningful Use

More information

Definitions and Acronyms

Definitions and Acronyms 1. Definitions Definitions and Acronyms ACA Expansion Members means individuals less than 65 years of age with income below 138% of the federal poverty level and former foster children up to the age of

More information

Appendix A. Glossary

Appendix A. Glossary Glossary The following provides brief definitions and descriptions of terms, abbreviations, and acronyms often used in the conjunction with the Medicaid program. AI is an indicator in the CAP block on

More information

Idaho Medicaid EHR Incentive Program Acronyms and Terms

Idaho Medicaid EHR Incentive Program Acronyms and Terms Idaho Medicaid EHR Incentive Program Acronyms and Terms Acronym Definition AIU Adopt, Implement, Upgrade ALOS Average Length of Stay ARRA American Recovery and Reinvestment Act of 2009 ATCB Authorized

More information

Re: Legal Analysis of a Medicaid Managed Fee-for-Service Model and a Medicaid Fee-for Service Administrative Services Only (ASO) Model

Re: Legal Analysis of a Medicaid Managed Fee-for-Service Model and a Medicaid Fee-for Service Administrative Services Only (ASO) Model Re: Legal Analysis of a Medicaid Managed Fee-for-Service Model and a Medicaid Fee-for Service Administrative Services Only (ASO) Model Optum has developed a managed fee-for-service (MFFS) model that offers

More information

MEDICAID GLOSSARY ELIGIBILITY BENEFITS FINANCING ADMINISTRATION GLOSSARY APPENDICES

MEDICAID GLOSSARY ELIGIBILITY BENEFITS FINANCING ADMINISTRATION GLOSSARY APPENDICES Actuarially Sound The federal statutory standard to which capitation payments made by state Medicaid programs under risk contracts to managed care organizations (MCOs) are held. See Capitation Payment,

More information

http://health-information.advanceweb.com/editorial/content/printfriendly.aspx?cc=211...

http://health-information.advanceweb.com/editorial/content/printfriendly.aspx?cc=211... Page 1 of 6 HIM Abbreviations ADVANCE explains what all those letters mean. ADVANCE explains what all those letters mean. In HIM, there seems to be an abbreviation for everything--policies, agencies, rules

More information

November 9, 2011 Indiana Family and Social Services Administration

November 9, 2011 Indiana Family and Social Services Administration 280905 Indiana Medicaid Electronic Health Records (EHR) Incentive Program November 9, 2011 Indiana Family and Social Services Administration 280905 Overview Indiana s Health Information Technology (HIT)

More information

DMAP Services Directory. November 2010 Department of Human Services Division of Medical Assistance Programs

DMAP Services Directory. November 2010 Department of Human Services Division of Medical Assistance Programs DMAP Services Directory November 2010 Department of Human Services Division of Medical Assistance Programs DMAP mailing information Oregon DHS - Division of Medical Assistance Programs 500 Summer St NE,

More information

Nebraska Medicaid Annual Report

Nebraska Medicaid Annual Report Division of Medicaid & Long-Term Care Nebraska Medicaid Annual Report December 1, 2013 Prepared in Accordance with Neb. Rev. Stat. 68-908(4) Vivianne M. Chaumont, Director Division of Medicaid & Long-Term

More information

State Medicaid HIT Plan (SMHP) Overview

State Medicaid HIT Plan (SMHP) Overview State Medicaid HIT Plan (SMHP) Overview OMB Approval Number: 0938-1088 PURPOSE: The SMHP provides State Medicaid Agencies (SMAs) and CMS with a common understanding of the activities the SMA will be engaged

More information

Innovations Committee. Modernizing Medicaid: Medicaid Managed Care Program and Technology Toolkit

Innovations Committee. Modernizing Medicaid: Medicaid Managed Care Program and Technology Toolkit Innovations Committee Modernizing Medicaid: Medicaid Managed Care v1.0, April 26, 2013 Table of Contents 1. Overview and Instructions... 3 2. Seven Conditions and Standards... 4 3. Considerations by MITA

More information

MEDICAL ASSISTANCE BULLETIN

MEDICAL ASSISTANCE BULLETIN ISSUE DATE April 8, 2011 EFFECTIVE DATE April 8, 2011 MEDICAL ASSISTANCE BULLETIN NUMBER 03-11-01, 09-11-02, 14-11-01, 18-11-01 24-11-03, 27-11-02, 31-11-02, 33-11-02 SUBJECT Electronic Prescribing Internet-based

More information

APPENDIX 1-COMMONLY USED ABBREVIATIONS, ACRONYMS AND TERMS IN LONG-TERM CARE SETTINGS

APPENDIX 1-COMMONLY USED ABBREVIATIONS, ACRONYMS AND TERMS IN LONG-TERM CARE SETTINGS APPENDIX 1-COMMONLY USED ABBREVIATIONS, COMMONLY USED ABBREVIATIONS, ACRONYMS AND TERMS IN LONG-TERM CARE ADE Adverse Drug Event. ADL Activities of Daily Living. ADR Adverse Drug Reaction. AIMS Abnormal

More information

Glossary of Terms. Account Number/Client Code. Adjudication ANSI. Assignment of Benefits

Glossary of Terms. Account Number/Client Code. Adjudication ANSI. Assignment of Benefits Account Number/Client Code Adjudication ANSI Assignment of Benefits Billing Provider/Pay-to-Provider Billing Service Business Associate Agreement Clean Claim Clearinghouse CLIA Number (Clinical Laboratory

More information

Medicaid. Administration

Medicaid. Administration MEDICAID care is reasonable, necessary, and provided in the most appropriate setting. The PROs are composed of groups of practicing physicians. To receive Medicare payments, a hospital must have an agreement

More information

HEALTH INFORMATION TECHNOLOGY*

HEALTH INFORMATION TECHNOLOGY* GLOSSARY of COMMON TERMS and ACRONYMS In HEALTH INFORMATION TECHNOLOGY* (April 2011) AHIC American Health Information Community The AHIC was a federal advisory panel created by HHS to make recommendations

More information

STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT

STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT Page 1 PROFESSIONAL MEDICAL PERSONNEL AND SUPPORTING STAFF USED IN THE ADMINISTRATION OF THE PROGRAM AND THEIR RESPONSIBILITIES Attached is a description of the kinds and number of the medical assistance

More information

HIPAA Glossary of Terms

HIPAA Glossary of Terms ANSI - American National Standards Institute (ANSI): An organization that accredits various standards-setting committees, and monitors their compliance with the open rule-making process that they must

More information

Meaningful Use EHR Incentive Program

Meaningful Use EHR Incentive Program Meaningful Use EHR Incentive Program HITECH Health Information Technology for Economic and Clinical Health The HITECH Act was signed into law by President Barack Obama on February 17, 2009 as part of the

More information

An Overview of Medicaid in North Carolina *

An Overview of Medicaid in North Carolina * An Overview of Medicaid in North Carolina * Lisa J. Berlin Center for Child and Family Policy Duke University Abstract: In North Carolina, as in other states, Medicaid cost containment is an increasingly

More information

Glossary of Insurance and Medical Billing Terms

Glossary of Insurance and Medical Billing Terms A Accept Assignment Provider has agreed to accept the insurance company allowed amount as full payment for the covered services. Adjudication The final determination of the issues involving settlement

More information

Managed Care in New York

Managed Care in New York Managed Care in New York This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program

More information

Meaningful Use in a Nutshell

Meaningful Use in a Nutshell Meaningful Use in a Nutshell Compiled by Phyllis A. Patrick, MBA, FACHE, CHC January, 2011 Phyllis A. Patrick & Associates LLC phyllis@phyllispatrick.com MEANINGFUL USE Defining Meaningful Use Benefits

More information

DEPARTMENT OF HEALTH & HUMAN SERVICES MEDICAID PROGRAM OVERVIEW

DEPARTMENT OF HEALTH & HUMAN SERVICES MEDICAID PROGRAM OVERVIEW DEPARTMENT OF HEALTH & HUMAN SERVICES MEDICAID PROGRAM OVERVIEW North Carolina General Assembly Fiscal Research Division February 2005 Overview Purpose of Medicaid Impact of Medicaid - On the State Economy

More information

Summary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals

Summary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals Summary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals I. Children s Health Insurance Program (CHIP) Reauthorization Act of 2009 A. Funding for CHIP. The

More information

Division of Medical Assistance Programs. Services Directory

Division of Medical Assistance Programs. Services Directory Services Directory DMAP Organization Chart... 1 Quick reference... 2 Main contact information... 2 DMAP mail codes... 2 E-mail addresses by topic... 2 Helpful telephone numbers... 2 Office of the State

More information

Privacy and Security: Meaningful Use in Healthcare Organizations

Privacy and Security: Meaningful Use in Healthcare Organizations Privacy and Security: Meaningful Use in Healthcare Organizations Phyllis A. Patrick, MBA, FACHE, CHC July 20, 2011 Webinar Essentials 1. Session is currently being recorded, and will be available on our

More information

Santa Rosa Presents Webinar Series Electronic Health Records & Meaningful Use Incentives: Medicare & Medicaid

Santa Rosa Presents Webinar Series Electronic Health Records & Meaningful Use Incentives: Medicare & Medicaid Santa Rosa Presents Webinar Series Electronic Health Records & Meaningful Use Incentives: Medicare & Medicaid February 11, 2011 Chris Apgar, CISSP President Overview ARRA & Meaningful Use Rule Overview

More information

For. Planning and Research Related to Procurement of a Systems Integration, Enhancements to a MMIS, New Fiscal Agent, and a Replacement DSS

For. Planning and Research Related to Procurement of a Systems Integration, Enhancements to a MMIS, New Fiscal Agent, and a Replacement DSS Implementation ADVANCE PLANNING DOCUMENT For Systems Integrator/ Florida Medicaid Management Information System/ Fiscal Agent Operations/ Decision Support System For Planning and Research Related to Procurement

More information

INTERMEDIATE ADMINISTRATIVE SIMPLIFICATION CENTERS FOR MEDICARE & MEDICAID SERVICES. Online Guide to: ADMINISTRATIVE SIMPLIFICATION

INTERMEDIATE ADMINISTRATIVE SIMPLIFICATION CENTERS FOR MEDICARE & MEDICAID SERVICES. Online Guide to: ADMINISTRATIVE SIMPLIFICATION 02 INTERMEDIATE» Online Guide to: CENTERS FOR MEDICARE & MEDICAID SERVICES Last Updated: February 2014 TABLE OF CONTENTS INTRODUCTION: ABOUT THIS GUIDE... i About Administrative Simplification... 2 Why

More information

Affordable Care Act Reviews

Affordable Care Act Reviews Appendix A: Affordable Care Act Reviews Appendix A: Affordable Care Act Reviews New Programs and Initiatives Created by the Affordable Care Act... 1 Pre-Existing Condition Insurance Plans, 1101...2 Controls

More information

PROGRAM MANAGEMENT BUSINESS AREA PROGRAM MANAGEMENT REPORTING CHECKLIST PROGRAM MANAGEMENT REPORTING (PM) CHECKLIST

PROGRAM MANAGEMENT BUSINESS AREA PROGRAM MANAGEMENT REPORTING CHECKLIST PROGRAM MANAGEMENT REPORTING (PM) CHECKLIST STATE: DATE OF REVIEW: REVIEWER: PROGRAM MANAGEMENT REPORTING (PM) CHECKLIST PROGRAM MANAGEMENT REPORTING (PM) CHECKLIST BACKGROUND Background for this checklist: 1. This checklist is intended to assess

More information

Health Resources Division Rule Changes (Effective 7/1/14)

Health Resources Division Rule Changes (Effective 7/1/14) Health Resources Division Rule Changes (Effective 7/1/14) Health Resources Division Mega Rule: ARM 37.85.105 The department is amending ARM 37.85.105 to reflect a 2% increase in Medicaid fees to providers.

More information

Oregon Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Oregon

Oregon Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Oregon Mental Health and Substance Abuse Services in Medicaid and SCHIP in Oregon As of July 2003, 398,874 people were covered under Oregon s Medicaid/SCHIP programs. There were 380,546 enrolled in the Medicaid

More information

0372 SPECIAL TREATMENT COVER GROUPS

0372 SPECIAL TREATMENT COVER GROUPS 0372 SPECIAL TREATMENT COVER GROUPS 0372.05 MEDICARE PREMIUM PAYMENT PROGRAM REV:01/2014 A. Medicare is the federal health insurance to which individuals who are insured under the Social Security system

More information

on the status of a claim previously submitted to CMS for processing. A code that identifies the category a claim falls within.

on the status of a claim previously submitted to CMS for processing. A code that identifies the category a claim falls within. 270 Health Care Eligibility Benefit Inquiry 271 Health Care Eligibility Benefit Response 276 Health Care Claims Status Request 277 Health Care Claims Status Response 278 Health Care Services Request for

More information

Principles and Strategy for Accelerating Health Information Exchange (HIE)

Principles and Strategy for Accelerating Health Information Exchange (HIE) Principles and Strategy for Accelerating Health Information Exchange (HIE) I. Background As a nation, we are transforming health care delivery into a system that is patient-centered and value-based. Existing

More information

Appendix 4: SPA and Waiver Options to Enhance Concurrent Care Programs

Appendix 4: SPA and Waiver Options to Enhance Concurrent Care Programs Appendix 4: SPA and Waiver Options to Enhance Concurrent Care Programs Medicaid State Plan Options Each state describes its Medicaid program in the Medicaid State Plan. The State Plan specifies how the

More information

ecams MITA Alignment May 2011

ecams MITA Alignment May 2011 ecams MITA Alignment May 2011 For more information visit: http://www.cns-inc.com/solutions ecams,ruleit and emipp are registered trademarks of CNSI Copyright 2012, All rights reserved CNSI s ecams claims

More information

RULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION BUREAU OF TENNCARE

RULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION BUREAU OF TENNCARE RULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION BUREAU OF TENNCARE CHAPTER 1200-13-17 TENNCARE CROSSOVER PAYMENTS FOR MEDICARE TABLE OF CONTENTS 1200-13-17-.01 Definitions 1200-13-17-.04 Medicare

More information

Improving Data Interoperability: Opportunities for States

Improving Data Interoperability: Opportunities for States Improving Data Interoperability: Opportunities for States MITA: Medicaid Information Technology Architecture and Mental Health Rick Friedman Director, Division of State Systems Centers for Medicare & Medicaid

More information

Nebraska Medicaid Managed Long-Term Services and Supports

Nebraska Medicaid Managed Long-Term Services and Supports Background A significant shift in the management and administration of Medicaid services has taken place over the past several years with the growth of managed care. Full-risk managed care is a health

More information

FRAUD AND ABUSE (SECTION-BY-SECTION ANALYSIS)

FRAUD AND ABUSE (SECTION-BY-SECTION ANALYSIS) FRAUD AND ABUSE (SECTION-BY-SECTION ANALYSIS) (Information compiled from the Democratic Policy Committee (DPC) Report on The Patient Protection and Affordable Care Act and the Health Care and Education

More information

Expanded Support for Medicaid Health Information Exchanges

Expanded Support for Medicaid Health Information Exchanges Expanded Support for Medicaid Health Information Exchanges Joint Public Health Forum & CDC Nationwide Webinar April 21, 2016 CDC EHR Meaningful Use Webpage-Joint Public Health Forum & CDC Nationwide Webinars

More information

Fundamentals of MITA 3.0 CMS Perspective

Fundamentals of MITA 3.0 CMS Perspective Fundamentals of MITA 3.0 CMS Perspective Chuck Lehman Director, Division of State Systems Josh Volosov Health IT Specialist, Division of State Systems Overview of Changes The MITA Framework incorporates

More information

UPDATED. Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs

UPDATED. Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs UPDATED Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs Issued May 8, 2013 Updated Special Advisory Bulletin on the Effect of Exclusion from Participation

More information

An Overview of Wisconsin s Medical Assistance, BadgerCare, and SeniorCare Programs

An Overview of Wisconsin s Medical Assistance, BadgerCare, and SeniorCare Programs An Overview of Wisconsin s Medical Assistance, BadgerCare, and SeniorCare Programs Prepared by Marlia Moore and Charles Morgan Wisconsin Legislative Fiscal Bureau Medical Assistance W i sconsin s medical

More information

Managed Care in Florida

Managed Care in Florida in Florida This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program start date may

More information

Medicaid Eligibility and Enrollment (EE) Implementation Advanced Planning Document (IAPD) Template. Name of State Medicaid Agency:

Medicaid Eligibility and Enrollment (EE) Implementation Advanced Planning Document (IAPD) Template. Name of State Medicaid Agency: Name of State: Name of State Medicaid Agency: Name of Contact(s) at State Medicaid Agency: E-Mail Address(es) of Contact(s) at State Medicaid Agency: Telephone Number(s) of Contact(s) at State Medicaid

More information

County of Los Angeles Department of Mental Health Office of the Medical Director Managed Care Division Provider Relations Unit

County of Los Angeles Department of Mental Health Office of the Medical Director Managed Care Division Provider Relations Unit County of Los Angeles Department of Mental Health Office of the Medical Director Managed Care Division Provider Relations Unit FEE-FOR-SERVICES ISSUES WORK GROUP MEETING Welcome and Introductions Wednesday,

More information

Managed Care in Minnesota

Managed Care in Minnesota Managed Care in Minnesota This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program

More information

Florida Agency for Health Care Administration. Medicaid Enterprise System Procurement. Version 2

Florida Agency for Health Care Administration. Medicaid Enterprise System Procurement. Version 2 Medicaid Enterprise System Procurement Version 2 June 6, 2016 Florida Medicaid Procurement Strategy Change Log Version # Date Page # Change v.2 6/6/2016 4 Release of the SEAS ITN has been moved from July

More information

Fundamentals for success billing Arkansas Medicaid. Copyright 2010 Hewlett-Packard Development Company, L.P.

Fundamentals for success billing Arkansas Medicaid. Copyright 2010 Hewlett-Packard Development Company, L.P. Fundamentals for success billing Arkansas Medicaid 1 Fundamentals for success Professional series Agenda - Working with PCPs - Verifying eligibility - Learning the aid categories - Billing methods and

More information

GLOSSARY Accountable Care Organization/Global Payments (ACO) Acuity Factor Adverse Selection Adult Expansion Affordable Care Act (ACA)

GLOSSARY Accountable Care Organization/Global Payments (ACO) Acuity Factor Adverse Selection Adult Expansion Affordable Care Act (ACA) GLOSSARY A Accountable Care Organization/Global Payments (ACO) A group of health care providers who provide coordinated care, chronic disease management, and thereby improve the quality of care patients

More information

COMMON PATHWAYS TO ELIGIBILITY

COMMON PATHWAYS TO ELIGIBILITY IN THIS FACT SHEET: PENNSYLVANIA MEDICAID, SCHIP, AND STATE-FUNDED HEALTH PROGRAMS AUGUST 2008 An Overview of Pennsylvania s Publicly Funded Insurance Programs This summary is intended to assist professionals

More information

IMPLEMENTATION ADVANCE PLANNING DOCUMENT

IMPLEMENTATION ADVANCE PLANNING DOCUMENT IMPLEMENTATION ADVANCE PLANNING DOCUMENT Oklahoma Health Care Authority Medicaid Eligibility System Project Online Enrollment November 21, 2011 Submitted by the Oklahoma Health Care Authority On behalf

More information

Kaiser Permanente Comments on Health Information Technology, by James A. Ferguson

Kaiser Permanente Comments on Health Information Technology, by James A. Ferguson Kaiser Permanente Comments on Health Information Technology, by James A. Ferguson FTC Public Workshop: Innovations in Health Care Delivery 24 April, 2008 Kaiser Permanente Overview Established in 1945,

More information

CMS oral Health Initiative an opportunity for Dental Hygienists April 23 rd 2015 Nancy Gurzick, RDH, BSDH, MA

CMS oral Health Initiative an opportunity for Dental Hygienists April 23 rd 2015 Nancy Gurzick, RDH, BSDH, MA CMS oral Health Initiative an opportunity for Dental Hygienists April 23 rd 2015 Nancy Gurzick, RDH, BSDH, MA Course objectives Part I Federal and State Oral Health Programs Understanding Medicaid/Federal

More information

AMENDMENT. 1. Replace in Amendment # 13, Item #1, page 1 of 12, with the following:

AMENDMENT. 1. Replace in Amendment # 13, Item #1, page 1 of 12, with the following: HP ENTERPRISE SERVICES, LLC PAGE 1 OF 10 AMENDMENT It is hereby agreed by and between the State of Vermont, Agency of Human Services, Department of Vermont Health Access (hereafter referred to as the State

More information

NCPDP Electronic Prescribing Standards

NCPDP Electronic Prescribing Standards NCPDP Electronic Prescribing Standards September 2014 1 What is NCPDP? An ANSI-accredited standards development organization. Provides a forum and marketplace for a diverse membership focused on health

More information

Instructions for Completing the Initial System Assessment for Upcoming HIPAA Changes Due Date: (specify date)

Instructions for Completing the Initial System Assessment for Upcoming HIPAA Changes Due Date: (specify date) for Completing the Initial System Assessment for Upcoming HIPAA Changes Due Date: (specify date) Some major changes to the HIPAA federally mandated regulations are forthcoming. Therefore, it is essential

More information

The American Recovery and Reinvestment Act of 2009 Summary of Key Health Information Technology Provisions July 1, 2009

The American Recovery and Reinvestment Act of 2009 Summary of Key Health Information Technology Provisions July 1, 2009 The American Recovery and Reinvestment Act of 2009 Summary of Key Health Information Technology Provisions July 1, 2009 This document is a summary of the ARRA and offered for information only. As the term

More information

National Training Program

National Training Program National Training Program Module 12 Medicaid and the Children s Health Insurance Program Session Objectives This session will help you Describe eligibility, benefits, and administration of Medicaid Define

More information

ARRA, HITECH Act, and Meaningful Use

ARRA, HITECH Act, and Meaningful Use ARRA, HITECH Act, and Meaningful Use Overview American Recovery and Reinvestment Act Health Information Technology for Economic and Clinical Health (HITECH) Act Interoperability and Standards Meaningful

More information

Interoperability, A Federal Perspective

Interoperability, A Federal Perspective Interoperability, A Federal Perspective Joseph Bodmer, PMP, MPM Director, Division of State and Tribal Systems, OCSE Director, ACF Interoperability Initiative, ACF ERICSA 52nd Annual Training Conference

More information

Mental Health and Substance Abuse Services in Medicaid and SCHIP in Colorado

Mental Health and Substance Abuse Services in Medicaid and SCHIP in Colorado Mental Health and Substance Abuse Services in Medicaid and SCHIP in Colorado As of July 2003, 377,123 people were covered under Colorado s Medicaid and SCHIP programs. There were 330,499 enrolled in the

More information

Glossary of Billing Terms

Glossary of Billing Terms Glossary of Billing Terms Guide to Reading & Understanding Your Bill Account Number - number the patient's visit (account) is given by the hospital or medical provider for documentation and billing purposes.

More information

Maryland Medicaid Program: An Overview. Stacey Davis Planning Administration Department of Health and Mental Hygiene May 22, 2007

Maryland Medicaid Program: An Overview. Stacey Davis Planning Administration Department of Health and Mental Hygiene May 22, 2007 Maryland Medicaid Program: An Overview Stacey Davis Planning Administration Department of Health and Mental Hygiene May 22, 2007 1 Maryland Medicaid In Maryland, Medicaid is also called Medical Assistance

More information

Vermont s Health Services Enterprise (HSE)

Vermont s Health Services Enterprise (HSE) Vermont s Health Services Enterprise (HSE) Where People are at the Center of a Health & Human Services Vision that is Supported by an Integrated Health Information Technology (HIT) Platform December, 2013

More information

HIPAA Administrative Simplification and Privacy (AS&P) Frequently Asked Questions

HIPAA Administrative Simplification and Privacy (AS&P) Frequently Asked Questions HIPAA Administrative Simplification and Privacy (AS&P) Frequently Asked Questions ELECTRONIC TRANSACTIONS AND CODE SETS The following frequently asked questions and answers were developed to communicate

More information

Medicaid. Overview. Medicaid Eligibility

Medicaid. Overview. Medicaid Eligibility Medicaid The following are brief summaries of complex subjects as of November 1, 2009. They should be used only as overviews and general guides to the Medicare and Medicaid programs. The views expressed

More information

HealthTECH Workforce Forum Presents: Electronic Health Records Adoption: Driving to 2015 and Beyond

HealthTECH Workforce Forum Presents: Electronic Health Records Adoption: Driving to 2015 and Beyond HealthTECH Workforce Forum Presents: Electronic Health Records Adoption: Driving to 2015 and Beyond May 19 th, 2011 EHR Implementation Panel Moderator: Paula J. Magnanti, MT(ASCP) Founder & Managing Principal

More information

Medicare and Medicaid Programs; EHR Incentive Programs

Medicare and Medicaid Programs; EHR Incentive Programs Medicare and Medicaid Programs; EHR Incentive Programs Background The American Recovery and Reinvestment Act of 2009 establishes incentive payments under the Medicare and Medicaid programs for certain

More information

Maryland Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland

Maryland Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland As of July 2003, 638,662 people were covered under Maryland's Medicaid/SCHIP programs. There were 525,080 enrolled in the Medicaid

More information

A Healthy Florida Works Program. Policy Proposal. The smart choice for individuals and businesses in Florida

A Healthy Florida Works Program. Policy Proposal. The smart choice for individuals and businesses in Florida A Healthy Florida Works Program Policy Proposal The smart choice for individuals and businesses in Florida TABLE OF CONTENTS Introduction Executive Summary Program Description 3 5 6 Coverage Population

More information

NYS Medicaid E-Prescribing Incentive Program: Interface with HITECH and Meaningful Use

NYS Medicaid E-Prescribing Incentive Program: Interface with HITECH and Meaningful Use NYS Medicaid E-Prescribing Incentive Program: Interface with HITECH and Meaningful Use May, 2010 Presented by James J. Figge, M.D., M.B.A. Medical Director, Office of Health Insurance Programs Vision:

More information

Definitions. ARIZONA REVISED STATUTES (A.R.S.) - Laws of the State of Arizona.

Definitions. ARIZONA REVISED STATUTES (A.R.S.) - Laws of the State of Arizona. SECTION 2 Definitions 1931 - Eligible individuals and families under the 1931 provision of the Social Security Act, with household income levels at or below 100% of the Federal Poverty Level (FPL). ARIZONA

More information

OREGON DID NOT BILL MANUFACTURERS FOR REBATES FOR PHYSICIAN-ADMINISTERED DRUGS DISPENSED TO ENROLLEES OF MEDICAID MANAGED-CARE ORGANIZATIONS

OREGON DID NOT BILL MANUFACTURERS FOR REBATES FOR PHYSICIAN-ADMINISTERED DRUGS DISPENSED TO ENROLLEES OF MEDICAID MANAGED-CARE ORGANIZATIONS Department of Health and Human Services OFFICE OF INSPECTOR GENERAL OREGON DID NOT BILL MANUFACTURERS FOR REBATES FOR PHYSICIAN-ADMINISTERED DRUGS DISPENSED TO ENROLLEES OF MEDICAID MANAGED-CARE ORGANIZATIONS

More information

Frequently Asked Questions: Electronic Health Records (EHR) Incentive Payment Program

Frequently Asked Questions: Electronic Health Records (EHR) Incentive Payment Program 1. Where did the Electronic Health Records (EHR) Incentive Program originate? The American Recovery and Reinvestment Act (ARRA) was signed into law on February 17, 2009, and established a framework of

More information

NATIONAL HEALTH POLICY FORUM. January 2010

NATIONAL HEALTH POLICY FORUM. January 2010 NATIONAL HEALTH POLICY FORUM January 2010 TAKE 1: OVERY ACT FUNDING FLOWS Funding Source Program Distribution Agency Funding Use Fund Recipients / Beneficiaries Entitlement Funds Appropriated Funds Medicare

More information

The Role of Oversight and Monitoring and the Use of Analytics to Increase Effectiveness of your Compliance Program

The Role of Oversight and Monitoring and the Use of Analytics to Increase Effectiveness of your Compliance Program The Role of Oversight and Monitoring and the Use of Analytics to Increase Effectiveness of your Compliance Program Presented by: David Curé, Vice President and Chief Auditor Christopher Price, Sr. Director,

More information

The RCM Guy s 450 Most Important Terms for Revenue Cycle Management

The RCM Guy s 450 Most Important Terms for Revenue Cycle Management The RCM Guy s 450 Most Important Terms for Revenue Cycle Management Term ABN Acceptance Rate Access Account Account Number Accountable Care Organization (ACO) Definition The advanced beneficiary notice

More information

Chapter 5. Billing on the CMS 1500 Claim Form

Chapter 5. Billing on the CMS 1500 Claim Form Chapter 5 Billing on the CMS 1500 Claim Form This Page Intentionally Left Blank Fee-For-Service Provider Manual April 2012 Billing on the UB-04 Claim Form Chapter: 5 Page: 5-2 INTRODUCTION The CMS 1500

More information

Qtr 2. 2011 Provider Update Bulletin

Qtr 2. 2011 Provider Update Bulletin West Virginia Medicaid WEST VIRGINIA Department of Health & Human Resources Qtr 2. 2011 Provider Update Bulletin West Virginia Medicaid Provider Update Bulletin Qtr. 2, 2011 Volume 1 Inside This Issue:

More information

CHAPTER 600 PROVIDER QUALIFICATIONS AND PROVIDER REQUIREMENTS 600 CHAPTER OVERVIEW... 600-1 610 AHCCCS PROVIDER QUALIFICATIONS...

CHAPTER 600 PROVIDER QUALIFICATIONS AND PROVIDER REQUIREMENTS 600 CHAPTER OVERVIEW... 600-1 610 AHCCCS PROVIDER QUALIFICATIONS... 600 CHAPTER OVERVIEW... 600-1 REFERENCES... 600-2 610 AHCCCS PROVIDER QUALIFICATIONS... 610-1 EXHIBIT 610-1 AHCCCS PROVIDER TYPES 620 AHCCCS FFS MINIMUM NETWORK REQUIREMENTS... 620-1 630 MEDICAL RECORD

More information

Medical Assistance Programs Dictionary

Medical Assistance Programs Dictionary 1 of 5 5/3/2016 4:46 PM ( /searchresults/index.htm ) Citizens MENU ( /searchresults/index.htm ) Tom Wolf, Governor( https://www.governor.pa.gov/ ) Ted Dallas, Secretary( http://dhs.pa.gov/learnaboutdhs/dhsorganization/secretaryofhumanservices/index.htm

More information

Practice management system criteria checklist

Practice management system criteria checklist Practice management system criteria checklist The American Medical Association (AMA) and Medical Group Management Association (MGMA) have created the following checklist as a starting point for assessing

More information

MEDICAID PROGRAM INTEGRITY MANUAL CHAPTER 9 DATA ANALYSIS

MEDICAID PROGRAM INTEGRITY MANUAL CHAPTER 9 DATA ANALYSIS MEDICAID PROGRAM INTEGRITY MANUAL CHAPTER 9 DATA ANALYSIS Transmittals for Chapter 9 Table of Contents (Rev. 2, Issued: 10-10-14) CHAPTER 9 DATA ANALYSIS 9000 IDENTIFY POTENTIAL AUDIT SUBJECTS 9005 ALGORITHM

More information

Presentation to the Senate Finance Medicaid Subcommittee: Prevention and Detection of Fraud, Waste and Abuse

Presentation to the Senate Finance Medicaid Subcommittee: Prevention and Detection of Fraud, Waste and Abuse Presentation to the Senate Finance Medicaid Subcommittee: Prevention and Detection of Fraud, Waste and Abuse Douglas Wilson, Interim Inspector General Billy Millwee, Associate Commissioner for Medicaid/CHIP

More information

Pennsylvania Department Of Human Services ESC Error Status Code Descriptions 201 BILLING PROVIDER IDENTIFICATION NUMBER IS MISSING FROM CLAIM 202

Pennsylvania Department Of Human Services ESC Error Status Code Descriptions 201 BILLING PROVIDER IDENTIFICATION NUMBER IS MISSING FROM CLAIM 202 Pennsylvania Department Of Human Services ESC Error Status Code Descriptions 201 BILLING PROVIDER IDENTIFICATION NUMBER IS MISSING FROM CLAIM 202 BILLING PROVIDER IDENTIFICATION NUMBER IS IN INVALID FORMAT

More information

Essential Skills for Business Analysts in the Healthcare Domain

Essential Skills for Business Analysts in the Healthcare Domain #ASPEevents Essential Skills for Business Analysts in the Healthcare Domain Essential Skills for Business Analysts in the Healthcare Domain Presented By Mary C. Zarba, MBA Vail, Colorado Welcome!! One

More information

MITA Information Series

MITA Information Series MITA Information Series 1. What is MITA? An Overview 2. MITA and APDs 3. Planning for MITA An Introduction to Transition Planning 4. What is a MITA Hub? 5. Service-Oriented Architecture A Primer 6. The

More information

and the uninsured June 2005 Medicaid: An Overview of Spending on Mandatory vs. Optional Populations and Services

and the uninsured June 2005 Medicaid: An Overview of Spending on Mandatory vs. Optional Populations and Services I S S U E kaiser commission on medicaid and the uninsured June 2005 P A P E R Medicaid: An Overview of Spending on vs. Optional Populations and Services Medicaid is a federal-state program that provides

More information

1965-1969 1970-1974 1975-1979 1980-1984 1985-1989 1990-1994 1995-1999 2000-2004 2005-2009

1965-1969 1970-1974 1975-1979 1980-1984 1985-1989 1990-1994 1995-1999 2000-2004 2005-2009 1965-1969 1970-1974 1975-1979 1980-1984 1985-1989 1990-1994 1995-1999 2000-2004 2005-2009 Intro Entire Timeline Displaying: 1965-2009 1965-2009 1965: Medicaid and Medicare passed by the U.S. House of Representatives

More information