Category: C

In the Federal budget, legislation enacted by the Congress to provide budget authority for specific ongoing activities in a fiscal year in cases where the regular appropriation for such activities has not been enacted by the beginning of the fiscal year. The continuing resolution usually specifies a maximum rate at which the agency may obligate…

Review during a patient’s hospitalization to determine the medical necessity and appropriateness of continuation of the patient’s stay at a hospital level of care. It may also include assessment of the quality of care being provided. Occasionally used for similar review of patients in other health facilities. Used in the PSRO and Medicare programs where…

Reserves set aside by an insurance company for unforeseen or unplannable circumstances and expenses other than the normal losses incurred by the risks insured.  

Fees based or conditioned on future occurrences or conclusions, or on the results of service to be performed. Contingency fees are used by lawyers representing patients as plaintiffs in malpractice cases and are usually a set fraction (commonly a third) of any settlement awarded the patient. If no settlement is awarded, the lawyer is not…

Services required of each community mental health center (CMHC) by section 201 of the CMHC Act which consist of consultation with, and education for, the staffs of programs and institutions in the CMHC’s community which are likely to be responsible for or come in contact with people with mental illness (such as schools, prisons, bars…

In the Federal budget, the budget as set forth by Congress in a concurrent resolution on the budget. These resolutions shall include: the appropriate level of total budget outlays and of total new budget authority, an estimate of budget outlays and new budget authority for each major functional category, for contingencies, and for undistributed intra-governmental…

Private or secret information, practices, or procedures. Confidentiality, as of a medical record, refers to the degree and circumstances in which information in such a record is private or secret. Information which is held confidential may include medical, financial or other information about patients obtained in the course of medical practice, and information about the…

In Congress, a formal meeting of representatives of the House and Senate at which the differences between House and Senate versions of a single piece of legislation or policy are resolved. The members of the House and Senate chosen to conduct the conference are called managers and together form the conference committee. They jointly recommend…

The various conditions which a provider (eg. hospital, skilled nursing facility) or supplier of services desiring to participate in the Medicare program is required to meet before participation is permitted. These conditions are specified in the statute and regulations and include compliance with tittle VI of the Civil Rights Act, signing an agreement to participate…

Review of the medical necessity of hospital or other health facility admissions upon or within a short period following an admission and the periodic review of services provided during the course of treatment. The initial review usually assigns an appropriate length of stay to the admission (using diagnosis specific criteria) which may also be reassessed…