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3M 3M Health Information System
A
A1c Hemoglobin A1c
AAA Abdominal Aortic Aneurysms
AAMC Association of American Medical Colleges
ABC Achievable Benchmark of Care
ABCTM Achievable Benchmark of Care
ACA The Patient Protection and Affordable Care Act
ACGME Accreditation Council for Graduate Medical Education
ACO Accountable Care Organization
ACoS American College of Surgeons
ACOT Advisory Committee on Organ Transplantation
AHA American Hospital Association
AHIC American Health Information Community
AHIMA American Health Information Management Association
AHRQ Agency for Healthcare Research and Quality
AJCC American Joint Committee on Cancer
ALOS Average Length of Stay
ALTHA Acute Long Term Hospital Association
AMA American Medical Association
AMGA American Medical Group Association
AMI Acute Myocardial Infarction
AOA American Osteopathic Association
APC Ambulatory Payment Classification
APM Alternative Payment Model
APR DRG All Patient Refined Diagnosis Related Group System
APRN Advanced Practice Registered Nurse
APU Annual payment update
ARRA American Recovery and Reinvestment Act
ASC Ambulatory Surgical Center
ASCA Administrative Simplification Compliance Act
ASCQR Ambulatory Surgical Center Quality Reporting
ASITN American Society of Interventional and Therapeutic Neuroradiology
ASP Average sales price
ASPE HHS’ Office of the Assistant Secretary for Planning and Evaluation
ATA American Telehealth Association
ATRA American Taxpayer Relief Act
AUC Appropriate use criteria
AWP Average wholesale price
AWV Annual Wellness Visit
B
BBA Balanced Budget Act
BBRA Balanced Budget Refinement Act
BBRA Medicare, Medicaid, and SCHIP [State Children’s Health Insurance Program] Balanced Budget Refinement Act
BCBSMA Blue Cross Blue Shield of Massachusetts
BCPI Bundled Payments for Care Improvement
BIPA Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act
BLS Bureau of Labor Statistics
BPCI Bundled Payments for Care Improvement
C
CABG Coronary Artery Bypass Graft [surgery]
CAD Coronary Artery Disease
CAH Critical Access Hospital
CAHPS Consumer Assessment of Healthcare Providers and Systems Care Practice
CAHs Critical Access Hospitals
CAP Competitive Acquisition Program
C–APC Comprehensive Ambulatory Payment Classification
CARE [Medicare] Continuity Assessment Record & Evaluation [Instrument]
CART CMS Abstraction & Reporting Tool
CASPER Certification and Survey Provider Enhanced Reporting
CAUTI Catheter-Associated Urinary Tract Infection
CBIC Competitive Bidding Implementation Contractor
CBSA Core-Based Statistical Area
CBSAs Core-based Statistical Areas
CC Complication or comorbidity
CCI Correct Coding Initiative
CCM Chronic Care Management
CCN CMS Certification Number
CCR Cost-to-Charge Ratio
CDAC [Medicare] Clinical Data Abstraction Center
CDAD Clostridium Difficile-Associated Disease
CDC Center for Disease Control and Prevention
CDS Clinical Decision Support
CED Coverage with Evidence Development
CEHRT Certified EHR Technology
CEO Chief executive officer
CERT Comprehensive Error Rate Testing
CF Conversion Factor
CfC Conditions of coverage
CFR Code of Federal Regulations
CG-CAHPS Clinician and Group Consumer Assessment of Healthcare Providers and Systems
CHCs Community Health Centers
CHIP Children's Health Insurance Program
CIPI Capital Input Price Index
CJR Comprehensive Care for Joint Replacement
CLABSI Central Line [Catheter] Associated Blood Stream Infection
CLFS Clinical Laboratory Fee Schedule
CMHC Community mental health center
CMI Case-Mix Index
CMMI Center for Medicare & Medicaid Innovation (CMS Innovation Center)
CMP Civil Monetary Penalties
CMS Centers for Medicare & Medicaid Services
CMSA Consolidated Metropolitan Statistical Area
CNM Certified Nurse Midwife
CoA Certificate of Accreditation
CoC Certificate of Compliance
COI Collection of Information
COLA Cost-of-Living Adjustment
CoP [Hospital] condition of participation
COPD Chronis obstructive pulmonary disease
CoR Certificate of Registration
CP Clinical Psychologist
CPC Comprehensive Primary Care
CPEP Clinical Practice Expert Panel
CPI Clinical Practice Improvement
CPI Consumer Price Index
CPIA Clinical Practice Improvement Activity
CPI–U Consumer Price Index for All Urban Consumers
CPOE Computerized Provider Order Entry
CPR Customary Prevailing and Reasonable
CPR Customary, Prevailing, and Reasonable
CPS Composite Performance Score
CPT Current Procedural Technology
CPT Current Procedural Terminology
CQM Clinical Quality Measure
CR Change request
CRC Colorectal cancer
CRNA Certified registered nurse anesthetist
CSAC Consensus Standards Approval Committee
CSW Clinical Social Worker
CT Computed Tomography
CV Coefficient of variation
CW Certificate of Waiver
CWF Common Working File
CY Calendar Year
D
DACA Data Accuracy and Completeness Acknowledgement
DFAR Defense Federal Acquisition Regulations
DFO Designated Federal Official
DHHS Department of Health and Human Services
DHS Designated Health Services
DI Diagnostic Imaging Services
DIR Direct or indirect remuneration
DM Diabetes Mellitus
DME Durable medical equipment
DMEPOS Durable Medical Equipment, Prosthetics/Orthotics, and Supplies Fee Schedule
DOB Date of Birth
DOJ Department of Justice
DPP Disproportionate Patient Percentage
DRA Deficit Reduction Act
DRG Diagnosis-Related Group
DSH Disproportionate Share Hospital
DSMT Diabetes Self-Management Training
DUA Data use Agreement
E
E/M Evaluation and Management
EACH Essential access community hospital
EAM Extended assessment and management
EBRT External beam radiotherapy
ECD Expanded criteria donor
ECG Electrocardiogram
ECI Employment Cost Index
eCQM Electronic Clinical Quality Measures
ECT Electroconvulsive therapy
ED Emergency Department
EDB [Medicare] Enrollment Database
EDTC Emergency department transfer communication
EHR Electronic Health Record
EMR Electronic medical record
EMT Emergency Medical Technician
EMTALA Emergency Medical Treatment and Labor Act
EP Eligible Professional
eRx Electronic Prescribing Incentive Program
ESRD End-stage Renal Disease
ESRD QIP End-Stage Renal Disease Quality Improvement Program
F
FACA Federal Advisory Committee Act
FAH Federation of American Hospitals
FAR Federal Acquisition Regulations
FDA Food and Drug Administration
FFS Fee-for-Service
FFY Federal fiscal year
FPL Federal poverty line
FQHC Federally Qualified Health Center
FQHCs Federally Qualified Health Centers
FR Federal Register
FSHCAA Federally Supported Health Centers Assistance Act
FTC Federal Trade Commission
FTE Full-time equivalent
FY Fiscal year
G
GAF Geographic Adjustment Factor
GAO Government Accountability Office
GI Gastrointestinal
GME Graduate medical education
GPCI Geographic Pricing Cost Index
GPO Group Purchasing Organization
GPRO Group Practice Reporting Option
GTR Genetic Testing Registry
H
HAC Hospital-Acquired Condition
HAI Healthcare-Associated Infection
HCAHPS Hospital Consumer Assessment of Health care Provider and Systems
HCC Hierarchal Condition Category
HCERA Health Care and Education Reconciliation Act
HCFA Health Care Financing Administration
HCO High-cost outlier
HCP Health care personnel
HCPCS Healthcare Common Procedure Coding System
HCRIS Healthcare Cost Report Information System
HCUP Healthcare Cost and Utilization Project
HEU Highly enriched uranium
HH QRP Home Health Quality Reporting Program
HHA Home Health Agency
HHAs Home Health Agencies
HHS Department of Health and Human Services
HICAN Health Insurance Claims Account Number
HICN Health Insurance Claim Number
HIE Health Information Exchange
HIPAA Health Insurance Portability and Accountability Act
HIPC Health Information Policy Council
HIS Health Information System
HIT Health Information Technology
HITECH Health Information Technology for Economic and Clinical Health
HMO Health Maintenance Organization
HOP Hospital Outpatient Payment [Panel]
HOP QDRP Hospital Outpatient Quality Data Reporting Program
HOPD Hospital Outpatient Department
HPMP Hospital Payment Monitoring Program
HPMS Health Plan Management System
HPSA Health professional Shortage Area
HQA Hospital Quality Alliance
HQI Hospital Quality Initiative
HRSA Health Resources and Services Administration
HSA Health Savings Account
HSCRC [Maryland] Health Services Cost
HSRVcc Hospital-specific Relative Value Cost Center
HVBP Hospital Value Based Purchasing
I
I/OCE Integrated Outpatient Code Editor
IBD Inflammatory bowel disease
IBR Intern- and Resident-to-Bed Ratio
ICC Interclass correlation coefficient
ICD Implantable cardioverter defibrillator
ICD–10 International Classification of Diseases
ICD–10–CM International Classification of Diseases, Tenth Revision, Clinical Modification
ICD–10–PCS International Classification of Diseases, Tenth Revision, Procedure Coding System Diseases
ICD–9–CM International Classification of Diseases, Ninth Revision, Clinical Modification
ICH In-center hemodialysis
ICR Information Collection Requirement
ICU Intensive care unit
IDTF Independent Diagnostic Testing Facility
IGI IHS Global Insight, Inc.
IHS Indian Health Service
IME Indirect medical education
IMRT Intensity Modulated Radiation Therapy
I–O Input-Output
IOL Intraocular lens
IOM Institute of Medicine
IORT Intraoperative radiation treatment
IPF Inpatient psychiatric facility
IPFQR Inpatient Psychiatric Facility Quality Reporting
IPPE Initial Preventive Physical Exam
IPPS [Hospital] Inpatient Prospective Payment System
IQR [Hospital] Inpatient Quality Reporting
IRF Inpatient Rehabilitation Facility
IRF QRP Inpatient Rehabilitation Facility Quality Reporting Program
IRS Internal Revenue Service
ISO Insurance Service Office
IT Information Technology
IWPUT Intensity of Work Per Unit of Time
L
LAMCs Large area metropolitan counties
LCD Local Coverage Determination
LDO Large Dialysis Organization
LDR Low dose rate
LOS Length of Stay
LTC–DRG Long-term care diagnosis-related group
LTCH Long-Term Care Hospital
LTCHQR Long-Term Care Hospital Quality Reporting
LTCHs Long-Term Acute Care Hospitals
M
MA Medicare Advantage (Plan)
MAC Medicare Administrative Contractor
MACRA Medicare Access and CHIP Reauthorization Act
MAP Measure Applications Partnership
MAPCP Multipayer Advanced Primary Care Practice
MA-PD Medicare Advantage Prescription Drug (Plan)
MAV Measure Application Validity Process
MCC Major complication or comorbidity
MCE Medicare Code Editor
MCO Managed care organization
MCP Monthly Capitation Payment
MDC Major diagnostic category
MDH Medicare-dependent, small rural hospital
MedPAC Medicare Payment Advisory Commission
MedPAR Medicare Provider Analysis and Review File
MEG Magnetoencephalography
MEI Medicare Economic Index
MFP Multi-Factor Productivity
MGCRB Medicare Geographic Classification Review Board
MHCQ Medicare Health Care Quality
MIEA-TRHCA Medicare Improvements and Extension Act
MIPPA Medicare Improvements for Patients and Providers Act
MIPS Merit-based Incentive Payment Programs
MLR Medical loss ratio
MMA Medicare Prescription Drug, Improvement and Modernization Act
MMEA Medicare and Medicaid Extenders Act
MMSEA Medicare, Medicaid, and SCHIP Extension Act
MP Malpractice
MPFS Medicare Physician Fee Schedule
MPPR Multiple Procedure Payment Reduction
MR Medical review
MRA Magnetic Resonance Angiography
MRgFUS Magnetic Resonance Image Guided Focused Ultrasound
MRHFP Medicare Rural Hospital Flexibility Program
MRI Magnetic Resonance Imaging
MRSA Methicillin-resistant Staphylococcus Aureus
MSA Metropolitan Statistical Area
MS–DRG Medicare Severity Diagnosis Related Group
MS-DRGs Medicare Severity-Adjusted Diagnosis Related Groups
MSIS Medicaid Statistical Information System
MS–LTC–DRG Medicare severity long-term care diagnosis-related group
MSP Minimum Savings Percentage
MSPB Medicare Spending per Beneficiary
MSR Minimum Savings Rate
MSSP Medicare Shared Savings Program
MU Meaningful Use
MUA Medically Underserved Area
MUC Measure under consideration
N
NAICS North American Industrial Classification System
NALTH National Association of Long Term Hospitals
NCCCN North Carolina Community Care Network
NCCI National Correct Coding Initiative
NCD National Coverage Determination
NCHS National Center for Health Statistics
NCQA National Committee for Quality Assurance
NCQDIS National Coalition of Quality Diagnostic Imaging Services
NCVHS National Committee on Vital and Health Statistics
NDC National Drug Code
NECMA New England County Metropolitan Areas
NEMA National Electrical Manufacturers Association
NHSN National Healthcare Safety Network
NOP Notice of Participation
NOS Not otherwise specified
NOTA National Organ and Transplantation Act
NP Nurse Practitioner
NPI National Provider Identifier
NPP Nonphysician Practitioner
NPWT Negative Pressure Wound Therapy
NQF National Quality Forum
NQS National Quality Strategy
NRDR National Radiology Data Registry
NTIOL New technology intraocular lens
NTIS National Technical Information Service
NTTAA National Technology Transfer and Advancement Act
NUBC National Uniform Billing Committee
NVHRI National Voluntary Hospital Reporting Initiative
O
OR Operating room
O/E Observed to expected event
OACT [CMS] Office of the Actuary
OBRA ’90 Omnibus Budget Reconciliation Act of 1990
OBRA '86 Omnibus Budget Reconciliation Act
OBRA Omnibus Budget Reconciliation Act
OCM Oncology Care Model
OIG [HHS] Office of the Inspector General
OMB Office of Management and Budget
ONC Office of the National Coordinator for Health Information Technology
OPD [Hospital] Outpatient Department
OPM [U.S.] Office of Personnel Management
OPO Organ Procurement Organization
OPPS [Hospital] Outpatient Prospective Payment System
OPSF Outpatient Provider-Specific File
OPTN Organ Procurement and Transplantation Network
OQR [Hospital] Outpatient Quality Reporting
OSCAR Online Survey Certification and Reporting [System]
OT Occupational Therapy
P
PA Physician Assistant
PACE Program of All Inclusive Care for the Elderly
PACFs Post-Acute Care Facilities
PAMA Protecting Access to Medicare Act
PAMPA Patient Access and Medicare
PAYGO Pay-as-you-go
PBD Provider-Based Department
PC Professional Component
PCH PPS-Exempt Cancer Hospital
PCHQR PPS-Exempt Cancer Hospital Quality Reporting
PCMH Patient Centered Medical Home
PCPI Physician Consortium for Performance Improvement
PCR Payment-to-cost ratio
PDC Per day cost
PDE Prescription Drug Event
PE Practice Expense
PE/HR Practice expense per hour
PECOS Medicare Provider Enrollment, Chain, and Ownership System
PEPPER Program Evaluation Payment Patterns Electronic Report
PFPMs Physician Focused Payment Models
PFS Physician Fee Schedule
PGP Physician Group Practice
PHI Protected health information
PHP Partial hospitalization program
PHS Public Health Service Act
PHSA Public Health Service Act
PLI Professional Liability Insurance
PMA Premarket Approval
PMSAs Primary Metropolitan Statistical Areas
PN Pneumonia
POA Present on Admission
POS Place of service
PPI Producer Price Index
PPIS Physician Practice Expense Information Survey
PPM Provider-Performed Microscopy
PPO Preferred provider organization
PPS Prospective payment system
PQRI Physician Quality Reporting Initiative
PQRS Physician Quality Reporting System
PRA Paperwork Reduction Act
PRM Provider Reimbursement Manual
ProPAC Prospective Payment Assessment Commission
PRRB Provider Reimbursement Review Board
PRTFs Psychiatric Residential Treatment Facilities
PS&R Provider Statistical and Reimbursement [System]
PSA Primary Service Areas
PSF Provider-Specific File
PSI Patient Safety Iindicator
PT Physical Therapy
PT Proficiency Testing
PT/INR Prothrombin Time/International Normalized Ratio
PTAC Physician-Focused Payment Model Technical Advisory Committee
PY Performance Year
Q
QA Quality Assessment
QC Quality Control
QCDR Qualified Clinical Data Registry
QDC Quality data code
QE Qualified Entities
QI Qualifying Individual
QIG Quality Improvement Group [CMS]
QIO Quality Improvement Organization
QP Qualified APM Professional
QRDA Quality Reporting Document Architecture
QRUR Quality and Resource Use Report
R
RAC Recovery Audit Contractor
RBRVS Resource-Based Relative Value Scale
RCE Reasonable compensation equivalent
RFA Regulatory Flexibility Act
RFI Request for Information
RHC Rural Health Clinic
RHCs Rural Health Clinics
RHQDAPU Reporting hospital quality data for annual payment update
RIA Regulatory Impact Analysis
RNHCI Religious nonmedical health care Institution
RPL Rehabilitation psychiatric long-term Care (Hospital)
RRC Rural referral center
RSMR Risk-standardized mortality rate
RSRR Risk-standard readmission rate
RTI Research Triangle Institute, International
RUC American Medical Association/Specialty Society Relative (Value) Update Committee
RUCA Rural Urban Commuting Area
RUCAs Rural-urban commuting area codes
RVU Relative Value Unit
RY Rate year
S
SAD Self-administered drug
SAF Standard Analytic File
SAMS Secure Access Management Services
SBA Small Business Administration
SCH Sole community hospital
SCIP Surgical Care Improvement Project
SCOD Specified covered outpatient drugs
SES Socioeconomic status
SFY State fiscal year
SGR Sustainable Growth Rate
SI Status indicator
SIA Systems Improvement Agreement
SIC Standard Industrial Classification
SIM State Innovation Model
SIR Standardized infection ratio
SLP Speech-language Pathology
SMS Socioeconomic Monitoring System
SNF Skilled Nursing Facility
SNFs Skilled Nursing Facilities
SOCs Standard occupational classifications
SOM State Operations Manual
SRS Stereotactic radiosurgery
SRTR Scientific Registry of Transplant Recipients
SSA Social Security Administration
SSI Supplemental Security Income
SSI Surgical Site Infection
SSN Social Security Number
SSO Short-Stay Outlier
SUD Substance Use Disorder
T
TAP Technical Advisory Panel
TC Technical Component
TCM Transitional Care Management
TCPI Transforming Clinical Practice Initiative
TEFRA Tax Equity and Fiscal Responsibility Act
TEP Technical expert panel
TIN Tax Identification Number
TIP Transprostatic implant procedure
TMA Transitional Medical Assistance Program
TMS Transcranial Magnetic Stimulation Therapy
TOPs Transitional Outpatient Payments
TPS Total Performance Score
U
UHDDS Uniform hospital discharge data set
UMRA Unfunded Mandate Reform Act
UPIN Unique Physician Identification Number
UR Utilization review
USC United States Code
USPSTF United States Preventive Services Task Force
UTI Urinary tract infection
V
VBP [Hospital] Value Based Purchasing Program
VM Value-based Payment Modifier
VPS Volume Performance Standard
VTE Venous Thromboembolism
W
WAC Wholesale acquisition cost