Glossary & Acronyms

Use this handy Glossary and Acronyms reference guide to help make sense of Medicare coverage options. Please choose one of the following to begin:
GlossaryAcronyms
ABCDEFGHIJKLMNOPQRSTUVWXYZ
A
ABNAdvanced beneficiary notice
ADAPAIDS Drug Assistance Program
AEPAnnual coordinated election period
AHRQAgency for Healthcare Research and Quality
AI/ANAmerican Indians and Alaska Natives
AICAmount in controversy
ALJAdministrative Law Judge
AMAAmerican Medical Association
AMCPAcademy of Managed Care Pharmacy
ANCIAmerican National Standards Institute
AOAccreditation organization
ASAPAmerican Society of Automation in Pharmacy
ASHPAmerican Society of Health Systems Pharmacists
AWPAverage wholesale price
B
BBABalanced Budget Act
BLSBureau of Labor Statistics
C
CAHPConsumer Assessment of Health Plan
CBIConfidential business information
CBOCongressional Budget Office
CCIPChronic care improvement programs
CCPComprehensive Compliance Program
CFRCode of Federal Regulations
CHOWChange of ownership
CMPCompetitive medical plan
CMSCenters for Medicare & Medicaid Services
COBCoordination of benefit
COBRAConsolidated Omnibus Budget Reconciliation Act (of 1985)
CPI-PDConsumer Price Index for Prescription Drugs and Medical Supplies
CPTCurrent Procedural Terminology
CYCalendar year
D
DABDepartmental Appeals Board
DHSDesignated health services
DMEDurable medical equipment
DoDDepartment of Defense
DOLDepartment of Labor
DURDrug utilization review
E
EOBExplanation of benefits
ERISAEmployee Retirement Income Security Act of 1974
ESRDEnd stage renal disease
F
FARFederal Acquisition Regulation
FDAFood and Drug Administration
FEHBPFederal Employee Health Benefits Program
FFPFederal financial participation
FOIAFreedom of Information Act
FPLFederal poverty level
FQHCsFederally qualified health centers
FRFederal Register
FSAFlexible savings account
FYFiscal year
G
H
HEDISHealth plan Employer Data and Information Set
HHSDepartment of Health and Human Services
HICHealth insurance claim
HIPAAHealth Insurance Portability and Accountability Act of 1996
HMOHealth maintenance organization
HPMSHealth Plan Management System
HRAHealth reimbursement account
HRSAHealth Resources and Services Administration
HSAHealth savings account
I
I/T/UIndian Tribes and Tribal organizations, and urban Indian organizations
ICFs/MRIntermediate care facilities for the mentally retarded
IDIQIndefinite duration, indefinite quantity
IEPInitial enrollment period
IHSIndian Health Service
IREIndependent review entity
J
JCHACOJoint Commission on Accreditation of Health Care Organizations
K
L
LISLow-income subsidy
LTCLong term care
M
MAMedicare Advantage (formerly Medicare+Choice)
MACMedicare Appeals Council
MA-PDMedicare Advantage prescription drug plans
MAXMedicaid Analytic extract
MCBSMedicare Current Beneficiary Survey
MMAMedicare Prescription Drug, Improvement, and Modernization Act of 2003
MSAMedicare savings account
MSISMedicaid Statistical Information System
MSPMedicare Secondary Payor
MTMPMedication Therapy Management Program
N
NAICNational Association of Insurance Commissioners
NCPDPNational Council for Prescription Drug Programs
NCQANational Committee for Quality Assurance
NCVHSNational Center for Vital and Health Statistics
NDCNational Drug Code
NHENational Health Expenditure
NPANational PACE Association
NPINational Provider Identifier
O
OACTOffice of the Actuary (CMS)
OBRAOmnibus Budget Reconciliation Act
OCROffice for Civil Rights
OEPIOpen enrollment period for institutionalized individuals
OIGOffice of the Inspector General
OPMOffice of Personnel Management
P
P&TPharmaceutical and therapeutic
PBAPharmacy benefit administrator
PBMsPharmacy benefit managers
PBPPlan Benefit Package
PDPPrivate prescription drug plan
PDSCPhased-down State contribution
PFFSPrivate fee-for-service plan
PHIProtected health information
PhRMAPharmaceutical Manufacturers and Researchers of America
PPOPreferred provider organization
PPVPharmaceutical Prime Vendor
PSOProvider-sponsored organization
Q
QDWIsQualified disabled and working individuals
QIOQuality Improvement Organization
QISQualified individuals
QMBQualified Medicare beneficiaries
R
REACHRegional Education About Choices in Health
RHCRural Health Center
S
SCHIPState Childrens Health Insurance Program
SEPSpecial enrollment period
SHIPState health insurance assistance program
SLMBSpecial Low-Income Beneficiaries
SOWScope of work
SPAPState Pharmaceutical Assistance Program
SPDSummary Plan Description
SPOCSingle point of contact
SSASocial Security Administration
SSISupplemental Security Income
SSRISelective serotonin reuptake inhibitor
SSSGsSimilarly Sized Subscriber Groups
T
TANFTemporary assistance for needy families
TrOOPTrue out-of-pocket
U
U&CUsual and customary
URACUtilization Review Accreditation Commission
USPU.S. Pharmacopoeia
V
VADepartment of Veterans Affairs
VDSAVoluntary data sharing agreement
W
X
Y
Z