Glossary

Acronyms
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Term Sort descending Definition
ACCREDITATION FOR PARTICIPATION

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

ACCREDITED (ACCREDITATION)

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.

ACCREDITED STANDARDS COMMITTEE

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

ACT/LAW/STATUTE

Term for legislation that passed through Congress and was signed by the President or passed over his veto.

ACTIVITIES OF DAILY LIVING (ADL)*

Activities you usually do during a normal day such as getting in and out of bed, dressing, bathing, eating, and using the bathroom.

ACTUAL CHARGE

The amount of money a doctor or supplier charges for a certain medical service or supply. This amount is often more than the amount Medicare approves. (See Approved Amount; Assignment.)

ACTUARIAL BALANCE

The difference between the summarized income rate and the summarized cost rate over a given valuation period.

ACTUARIAL DEFICIT

A negative actuarial balance.

ACTUARIAL RATES

One half of the expected monthly cost of the SMI program for each aged enrollee (for the aged actuarial rate) and one half of the expected monthly cost for each disabled enrollee (for the disabled actuarial rate) for the duration the rate is in effect.

ACTUARIAL SOUNDNESS

A measure of the adequacy of Hospital Insurance and Supplementary Medical Insurance financing as determined by the difference between trust fund assets and liabilities for specified periods.