- Отрасли: Government
- Number of terms: 15199
- Number of blossaries: 0
- Company Profile:
The federal agency that runs the Medicare program. In addition, CMS works with the States to run the Medicaid program. CMS works to make sure that the beneficiaries in these programs are able to get high quality health care.
Policy developed by CMS Contractors (PSC, AC, FI, or carrier) and used to make coverage and coding determinations. It is developed when:
* there is an absence of national coverage policy for a service or all of the uses of a service;
* there is a need to interpret national coverage policy; or
* local coding rules are needed.
Industry:Insurance
Integrates the financing and delivery of appropriate health care services to covered individuals by means of: arrangements with selected providers to furnish a comprehensive set of health care services to members, explicit criteria for the selection of health care provides, and significant financial incentives for members to use providers and procedures associated with the plan. Managed care plans typically are labeled as HMOs (staff, group, IPA, and mixed models), PPOs, or Point of Service plans. Managed care services are reimbursed via a variety of methods including capitation, fee for service, and a combination of the two.
Industry:Insurance
Beginning in 1994, up to 85 percent of an individual's or a couple's OASDI benefits is potentially subject to federal income taxation under certain circumstances. The revenue derived from taxation of benefits in excess of 50 percent, up to 85 percent, is allocated to the HI trust fund.
Industry:Insurance
