Glossary

(See Grievance.)

(See Lifetime Reserve Days.)

(See State Health Insurance Assistance Program.)

60 day unit of payment for HH PPS.

A basic level of care usually given by doctors who work with general and family medicine, internal medicine (internists), pregnant women (obstetricians), and children (pediatricians). A nurse practitioner (NP), a State licensed registered nurse with special training, can also provide this basic level of health care.

A benchmark is sustained superior performance by a medical care provider, which can be used as a reference to raise the mainstream of care for Medicare beneficiaries. The relative definition of superior will vary form situation to situation. In many instances an appropriate benchmark would be a provider that appears in the top 10% of all providers for more than a year.

A Board established by the Social Security Act to oversee the financial operations of the Federal Supplementary Medical Insurance Trust Fund. The Board is composed of six members, four of whom serve automatically by virtue of their positions in the federal government: the Secretary of the Treasury, who is the Managing Trustee; the Secretary of Labor; the Secretary of Health and Human Services; and the Commissioner of Social Security. The other two members are appointed by the President and confirmed by the Senate to serve as public representatives. John L. Palmer and Thomas R. Saving began serving their 4-year terms on October 28, 2000. The Administrator of CMS serves as Secretary of the Board of Trustees.

A body that provides administrative services to X12 and several other standards-related groups.

A breakdown in a person's mental state that may affect a person's moods, fears, anxieties, and ability to think clearly.

A case developed after the PSC has substantiated an allegation of fraud.