Category: S

Dispensing a quantity of a drug which is less than the quantity prescribed for the purpose of increasing profit by charging for the prescribed amount.  

The coordinated, or otherwise explicitly agreed upon, sharing of responsibility for provision of medical or non-medical services on the part of two or more otherwise independent hospitals or other health programs. The sharing of medical services might include, for example, an agreement that one hospital provide all pediatric care needed in a community and no…

A patient whose care is the responsibility of a health program or institution (usually a hospital). Service patients are often cared for by an individual practitioner paid by the program (typically a member of a hospital’s housestaff), but the program, not the individual, is paid for the care. Sometimes called a public or ward patient.…

In the Veterans Administration health care program, a disability incurred or aggravated in the line of duty in active military service. In this context disability includes disease. These disabilities are the primary concern of the program.  

Those received as a result of prepayment or insurance, whereby payment is made directly to the provider of services or the hospital or other medical care programs for covered services provided by them to eligible persons. Service benefits may be full service benefits, meaning that the plan fully reimburses the hospital, for example, for all…

The practice of an individual, group of individuals, employer, or organization assuming complete responsibility for losses which might be insured against, such as malpractice losses, or medical expenses and other losses due to illness. In such cases, medical expenses would most likely be financed out of current income, personal savings, a fund developed for the…

A section of the Social Security Act added. The section provides that payments will not be made under Medicare or Medicaid with respect to certain disapproved capital expenditures determined to be inconsistent with State or local health plan, the National Health Planning and Resources Development Act of 1974, requires States participating in the section 1122…

A section of the PHS Act which authorizes formula grants by the Federal government to the States for their unrestricted use in funding State and local health programs and activities. Therefore sometimes called a health revenue sharing program. For some years the annual amount appropriated has been $90 million.  

A section of the Social Security Amendments of 1972, which places a limit for purposes of Medicare and Medicaid reimbursement on charges recognized as reasonable. The law recognizes as reasonable those charges which fall within the 75th percentile of all charges for a similar service in a locality. Increases in physicians’ fees allowable for Medicare…

A section of the Social Security Amendments of 1972, which requires the Secretary to establish limits on overall direct or indirect costs which will be recognized as reasonable under Medicare for comparable services in comparable facilities in an area. The Secretary is also permitted to establish maximum acceptable costs in such facilities with respect to…