Federal
General definitions.
42 CFR § 400.200
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42 CFR § 400.200
42 CFR § 400.200
General definitions. In this chapter, unless the context indicates otherwise—
Act
Act means the Social Security Act, and titles referred to are titles of that Act.
Administrator
Administrator means the Administrator, Centers for Medicare & Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA).
ALJ
ALJ stands for administrative law judge.
Area
Area means the geographical area within the boundaries of a State, or a State or other jurisdiction, designated as constituting an area with respect to which a Professional Standards Review Organization or a Utilization and Quality Control Peer Review Organization has been or may be designated.
Beneficiary
Beneficiary means a person who is entitled to Medicare benefits and/or has been determined to be eligible for Medicaid.
CMP
CMP stands for competitive medical plan.
Conditions of participation
Conditions of participation includes requirements for participation as the latter term is used in part 483 of this chapter.
Condition level
Condition level deficiencies includes deficiencies with respect to “level A requirements” as the latter term is used in parts 442 and 483 of this chapter.
CORF
CORF stands for comprehensive outpatient rehabilitation facility.
CFR
CFR stands for Code of Federal Regulations.
CMS
CMS stands for Centers for Medicare & Medicaid Services, formerly the Health Care Financing Administration (HCFA).
CY
CY stands for calendar year.
DAB
DAB stands for Departmental Appeals Board.
Department
Department means the Department of Health and Human Services (HHS), formerly the Department of Health, Education, and Welfare.
ESRD
ESRD stands for end-stage renal disease.
FDA
FDA stands for the Food and Drug Administration.
FQHC
FQHC means Federally qualified health center.
FR
FR stands for Federal Register.
FY
FY stands for fiscal year.
HCPP
HCPP stands for health care prepayment plan.
HHS
HHS stands for the Department of Health and Human Services.
HHA
HHA stands for home health agency.
HMO
HMO stands for health maintenance organization.
ICF
ICF stands for intermediate care facility.
ICF/IID
ICF/IID stands for intermediate care facility for individuals with intellectual disabilities.
Medicaid
Medicaid means medical assistance provided under a State plan approved under title XIX of the Act.
Medicare
Medicare means the health insurance program for the aged and disabled under title XVIII of the Act.
Medicare Savings Programs
Medicare Savings Programs (MSPs) has the same meaning described in § 435.4 of this chapter.
NCD
NCD stands for national coverage determination.
OASDI
OASDI stands for the Old Age, Survivors, and Disability Insurance program under title II of the Act.
OIG
OIG stands for the Department's Office of the Inspector General.
Public Health Emergency (PHE)
Public Health Emergency (PHE) means the Public Health Emergency determined to exist nationwide as of January 27, 2020, by the Secretary pursuant to section 319 of the Public Health Service Act on January 31, 2020, as a result of confirmed cases of COVID-19, including any subsequent renewals.
QDWI
QDWI stands for Qualified Disabled and Working Individual.
QIO
QIO stands for quality improvement organization.
QMB
QMB stands for Qualified Medicare Beneficiary.
Qualified Disabled and Working Individual
Qualified Disabled and Working Individual means an individual who—
(1)
Is eligible to enroll for Medicare Part A under section 1818A of the Act.
(2)
Has income, as determined in accordance with SSI methodologies, that does not exceed 200 percent of the Federal poverty guidelines (as defined and revised annually by the Office of Management and Budget) for a family of the size of the individual's family;
(3)
Has resources, as determined in accordance with SSI methodologies, that do not exceed twice the relevant maximum amount established, for SSI eligibility, for an individual or for an individual and his or her spouse; and
(4)
Is not otherwise eligible for Medicaid.
Qualified Medicare Beneficiary (QMB)
Qualified Medicare Beneficiary (QMB) means an individual described in § 435.123 of this chapter.
Qualifying Individual
Qualifying Individual (QI) means an individual described in § 435.125 of this chapter.
Quality improvement organization
Quality improvement organization means an organization that has a contract with CMS, under part B of title XI of the Act, to perform utilization and quality control review of the health care furnished, or to be furnished, to Medicare beneficiaries.
Regional Administrator
Regional Administrator means a Regional Administrator of CMS.
Regional Office
Regional Office means one of the regional offices of CMS.
RHC
RHC stands for rural health clinic.
RRB
RRB stands for Railroad Retirement Board.
Secretary
Secretary means the Secretary of Health and Human Services.
SNF
SNF stands for skilled nursing facility.
Specified Low-Income Medicare Beneficiary (SLMB)
Specified Low-Income Medicare Beneficiary (SLMB) means an individual described in § 435.124 of this chapter.
SSA
SSA stands for Social Security Administration.
United States
United States means the fifty States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
U.S.C
U.S.C stands for United States Code.
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