Glossary

An organization that has been accredited by ANSI for the development of American National Standards.

Means having a seal of approval. Being accredited means that a facility or health care organization has met certain quality standards. These standards are set by private, nationally recognized groups that check on the quality of care at health care facilities and organizations. Organizations that accredit Medicare Managed Care Plans include the National Committee for Quality Assurance, the Joint Commission on Accreditation of Healthcare Organizations, and the American Accreditation HealthCare Commission/URAC.

State requirement that plans must be accredited to participate in the Medicaid managed care program.

Some States use the findings of private accreditation organizations, in part or in whole, to supplement or substitute for State oversight of some quality related standards. This is referred to as "deemed compliance" with a standard.

The duration of CMS's recognition of the validity of an accrediting organization's determination that a Medicare + Choice organization (M+CO) is "fully accredited".

An evaluative process in which a healthcare organization undergoes an examination of its policies, procedures and performance by an external organization ("accrediting body") to ensure that it is meeting predetermined criteria. It usually involves both on- and off-site surveys.

A separate housing arrangement within a single-family home. The ADU is a complete living unit and includes a private kitchen and bath.

Your ability to get medical care and services when you need them.

Your ability to get needed medical care and services.

When another person does something on purpose that causes you mental or physical harm or pain.