Glossary

Acronyms
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Glossary and Acronyms
Term Definition
RIGHTS OF INDIVIDUALS
  • Receive notice of information practices;
  • See and copy own records;
  • Request corrections; Obtain accounting of disclosures;
  • Request restrictions and confidential communications;
  • File complaints
508
508 Compliance 
 CMS is also bound to producing what’s called 508 compliant applications. Julie Shadoan is the CMS voice you will here when this topic comes up. This link addresses CMS 508 process:http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/Section508/index.html.  On the left side there is a “Verification Process . . .” link that goes into more detail about how CMS verifies our applications are 508 compliant.
CONFIDENTIALITY

Your right to talk with your health care provider without anyone else finding out what you have said.
PLAN OF CARE

Your doctor's written plan saying what kind of services and care you need for your health problem.
ELECTION

Your decision to join or leave the Original Medicare Plan or a Medicare+Choice plan.
ACCESS

Your ability to get needed medical care and services.
ACCESSIBILITY OF SERVICES

Your ability to get medical care and services when you need them.
ELIGIBILITY/MEDICARE PART A

You are eligible for premium-free (no cost) Medicare Part A (Hospital Insurance) if:

  • You are 65 or older and you are receiving, or are eligible for, retirement benefits from Social Security or the Railroad Retrirement Board, or
  • You are under 65 and you have received Railroad Retirement disability benefits for the prescribed time and you meet the Social Security Act disability requirements, or
  • You or your spouse had Medicare-covered government employment, or
  • You are under 65 and have End-Stage Renal Disease (ESRD).

If you are not eligible for premium-free Medicare Part A, you can buy Part A by paying a monthly premium if:

  • You are age 65 or older, and
  • You are enrolled in Part B, and
  • You are a resident of the United States, and are either a citizen or an alien lawfully admitted for permanent residence who has lived in the United States continuously during the 5 years immediately before the month in which you apply.
ELIGIBILITY/MEDICARE PART B

You are automatically eligible for Part B if you are eligible for premium-free Part A. You are also eligible for Part B if you are not eligible for premium-free Part A, but are age 65 or older AND a resident of the United States or a citizen or an alien lawfully admitted for permanent residence. In this case, you must have lived in the United States continuously during the 5 years immediately before the month during which you enroll in Part B.
AUTHORITATIVE EVIDENCE

Written medical or scientific conclusions demonstrating the medical effectiveness of a service produced by the following:

  • Controlled clinical trials, published in peer-reviewed medical or scientific journals;
  • Controlled clinical trials completed and accepted for publication in peer-reviewed medical or scientific journals;
  • Assessments initiated by CMS;
  • Evaluations or studies initiated by Medicare contractors;
  • Case studies published in peer-reviewed medical or scientific journals that present treatment protocols.