Since its 1976 establishment, the Office of Inspector General of the U.S. Department of Health & Human Services (HHS) has been at the forefront of the Nation’s efforts to fight waste, fraud, and abuse in Medicare, Medicaid and more than 100 other HHS programs.
Further reading
A managed care organization (MCO) is a health care provider or a group or organization of medical service providers who offers managed care health plans. It is a health organization that contracts with insurers or self-insured employers and finances and delivers health care using a specific provider network and specific services and products.
They provide a wide variety of quality and managed health care services to enrolled workers keeping medical costs down through preventative medicine, patient education, and in other ways. These organizations are certified by the director of the Department of Consumer and Business Services (DCBS).
MCOs vary in their constitution as some organizations are made of physicians, while others are combinations of physicians, hospitals, and other providers. For instance, a group practice without walls, independent practice association, management services organization, and a physician practice management company are the common MCO’s.
Further reading
A fiscal intermediary is a private company contracted by Medicare to pay bills – such as hospital expenses – for Medicare Part A and Part B.
Further reading
https://definitions.uslegal.com/f/fiscal-intermediary-fi-health-care/
The Administration for Children and Families (ACF) is a division of the Department of Health & Human Services. We promote the economic and social well-being of children, families, individuals and communities with leadership and resources for compassionate, effective delivery of human services.
Further reading
A notice of proposed rulemaking (NPRM) is a public notice issued by law when one of the independent agencies of the United States government wishes to add, remove, or change a rule or regulation as part of the rulemaking process.
Further reading
https://www.federalregister.gov/uploads/2011/01/the_rulemaking_process.pdf
AMIA (the American Medical Informatics Association) is a professional scientific association that was formed by the merger of three organizations in 1988: the American Association for Medical Systems and Informatics (AAMSI); the American College of Medical Informatics (ACMI); and the Symposium on Computer Applications in Medical Care (SCAMC).
For more than 35 years, members of AMIA and its honorific college, ACMI, have sponsored meetings, education, policy, and research programs. AMIA continues to gain influence as the authoritative voice in the growing field of informatics through the individual and collective efforts of its members, who continue to drive thought leadership, and research and practice in their respective disciplines.
AMIA aims to lead the way in transforming health care through trusted science, education, and the practice of informatics. AMIA connects a broad community of professionals and students interested in informatics. AMIA is the bridge for knowledge and collaboration across a continuum, from basic and applied research to the consumer and public health arenas. AMIA actively supports five domains:
Translational Bioinformatics
Clinical Research Informatics
Clinical Informatics
Consumer Health Informatics
Public Health Informatics
AMIA’s program and services are centered around core purposes to:
advance the science of informatics
promote the education of informatics
assure that health information technology is used most effectively to promote health and health care
advance the profession of informatics
provide services for our members such as networking and opportunities for professional development.
Further reading
Utilization Review Accreditation Commission – URAC was originally incorporated under the name Utilization Review Accreditation Commission. That name was shortened to the acronym URAC in 1996 when it began accrediting other types of organizations such as health plans, pharmacies, and provider organizations.
Further reading
https://www.urac.org/about-urac/frequently-asked-questions/#acronym
State Children’s Health Insurance Program – The Children’s Health Insurance Program (CHIP) is a partnership between the federal and state governments that provides health coverage to uninsured children whose families earn too much to qualify for Medicaid, but too little to afford private health coverage.
Further reading
Qualified Medicare Beneficiaries – There are several programs to help people pay their Medicare expenses: The Qualified Medicare Beneficiary or QMB program; the Specified Low-income Medicare Beneficiary or SLMB program; and the Qualifying Individual or QI program.
Further reading
The Office of Management and Budget (OMB) is the largest office within the Executive Office of the President of the United States (EOP). OMB’s most prominent function is to produce the President’s Budget,[2] but OMB also measures the quality of agency programs, policies, and procedures to see if they comply with the president’s policies and coordinates inter-agency policy initiatives.
The current OMB Director is Mick Mulvaney. The OMB Director reports to the President, Vice President and the White House Chief of Staff.
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