GLOSSARY
of
Common health acronyms and other "Washington insider" terms – 2012
“The Administration”
President and his staff
ACOs
Accountable Care Organizations
AHRQ
Agency for Health Care Research and Quality
ARRA
American Reinvestment and Recovery Act of 2009 (stimulus package)
AIMS
Anesthesia information management systems
Blue Dogs
In general, conservative Democratic Representatives
Budget Control Act of 2011
Law enacted to reduce federal government spending
Cloture Vote
Vote in the Senate limiting debate, requiring 60 votes
CAH
Critical Access Hospital
CBC
Congressional Black Caucus
CBO
Congressional Budget Office, the accounting arm of the U.S. Congress
CER
Comparative effectiveness research
CF
Conversion factor
CMS
Centers for Medicare and Medicaid Services (formerly HCFA)
CMMI
Center for Medicare and Medicaid Innovation
Conditions of
Participation (COP)
Medicare/Medicaid accreditation standards for hospitals, critical access
hospitals and ambulatory care facilities
CPI
Consumer Price Index
DEA
Drug Enforcement Administration
Economic damages
Damages attributable to monetary losses such as medical expenses or lost
earnings
EHR
Electronic health records
EMR
Electronic medical records
ERISA
Employee Retirement Income Security Act, exempting self-insured
corporate health plans from state regulation
FOIA
Freedom of Information Act
FTC
Federal Trade Commission
FDA
Food and Drug Administration
GAO
Government Accountability Office, the investigative arm of Congress
GDP
Gross Domestic Product
HHS
Department of Health and Human Services
HIPAA
Health Insurance Portability and Accountability Act
HIT
Health information technology
HMO
Health maintenance organization
IPAB
Independent Payment Advisory Board
“Key committees”
Congressional committees that have primary jurisdiction over certain
issues. Key health care committees include House Ways & Means,
House Energy & Commerce, Senate Finance and Senate Health,
Education, Labor and Pensions (HELP)
In-District Work Periods
Periods of the legislative year in which lawmakers are typically not in
Washington, DC but are working locally.
“Innovation Center”
Center for Medicare and Medicaid Innovation or CMMI
IOM
Institute of Medicine
Main Street Republicans
In general, moderate Republican Representatives
“Market power”
Ability unilaterally to affect price or other marketplace competitive
conditions
MCO
Managed care organization, e.g. an HMO
Medicaid
A federal-state program to finance acute and long-term care
for poor and low-income individuals
Medical direction
Medicare standards for payment of medical direction
of nurse anesthetists and residents
Medicare
Federal health insurance plan for 65+ and certain disabled
persons
Medicare Anesthesia
Fee Schedule
Basis, closely patterned after ASA’s RVG, for determining payment
for anesthesia services to Medicare beneficiaries
Medicare Part A
Insurance covering hospital, home health (in transition),
hospice and some skilled nursing facility care
Medicare Part B
A voluntary insurance program covering physician and
certain other care, in exchange for a monthly premium
Medicare Advantage
Medicare managed care system, as an alternative to
fee-for-service
MedPAC
Medicare Payment Advisory Commission, a non-partisan advisory body
to the Congress
MEI
Medicare Economic Index (Medicare cost inflation measure)
MFS
Medicare Fee Schedule, under which physician services to
Medicare patients are paid
MICRA
California’s 1975 Medical Injury Compensation Reform Act
MIPPA
Medicare Improvements for Patients and Providers Act, signed into law
in July 2008. Provided positive Medicare physician payment update for
18 months, extended PQRI program and fixed Medicare anesthesiology
teaching rule.
MMA
Medicare Modernization Act of 2003
Mark-up
Consideration of a bill by a committee. Bill subject to revision by
amendment by committee member.
NIH
National Institutes of Health
Non-Economic damages
Subjective, non-monetary losses such as pain and suffering
OMB
Office of Management and Budget
ONC
Office of the National Coordinator
“Opt Out”
Gubernatorial decision to apply state law only to issue of supervision of
nurse anesthetists
Outcome
The consequence of health care intervention to a patient
Pay-for-Performance or P4P
A broad and loosely defined term that encompasses “process” or
“outcomes” standards that might be applied to physicians and other
healthcare professionals as an added payment reward or to otherwise
affect payment
PAC
Political Action Committee (not to be confused with
MedPAC or PPAC), as in ASAPAC
“Pass Through”
Medicare Part A payment for a hospitals’ reasonable costs
PPAC
Medicare Practicing Physicians Advisory Council
PPACA
Patient Protection and Affordable Care Act of 2010 (health reform law)
PQRI
Physician Quality Reporting Initiative, CMS-administered program
which rewards physicians for successfully reporting on relevant quality
measures
Private contracting
Contract between physician and Medicare beneficiary
outside the Medicare program
“Public plan”
Any government-sponsored health insurance plan created to compete
with commercial health insurers
Punitive damages
Damages for purposes of punishing the defendant for malicious or
reckless behavior
RBRVS
Medicare’s Resource-Based Relative Value Guide, under which
non-anesthetic physician payment is calculated
Reconciliation
Congressional procedure allowing the majority party to pass legislation
with a budgetary impact in an expedited fashion. Cannot be filibustered.
Resource-Based
Expenses
Resources involved in furnishing a service, including staff,
equipment and supplies
“Roe bill”
Representative Phil Roe’s bill to repeal IPAB
RUC
AMA-Specialty Society Relative Value Update Committee
“Rule of Reason”
An antitrust principle that measures the legality of conduct by weighing
pro-competitive against anti-competitive effects
Rural pass-through
A law that allow small rural hospitals to use Part A funds for anesthesia
services. Costs are “passed-through” to Medicare for reimbursement.
RVUs
Relative Value Units
“Score”
CBO estimate of budgeting impact of proposed legislation
SCOTUS
The Supreme Court of the United States
Sequestration
Across-the-board cuts to federal spending required by the Budget
Control Act of 2011
SGR
Sustainable Growth Rate, the Medicare Fee Schedule
update system
TEFRA
Tax Equity and Fiscal Responsibility Act of 1982, pursuant to
which the medical direction rules were created by HCFA
VBP
Value-based purchasing