Abbreviations

A
A A B C http://www.yahoo.com
A&G Administrative and General
A&I Audits and Investigations www.dhcs.ca.gov
AHA American Hospital Association www.aha.org/
APC Ambulatory Payment Classification
ARAS Audit Review and Analysis Section
ARRA American Recovery and Reinvestment Act of 2009
ASC Ambulatory Surgical Center

B
BBA Balanced Budget Act
BBRA Balanced Budget Reform Act
BIPA Benefits Improvement and Protection Act

C
CAH Critical Access Hospital www.cms.gov
CAP Competitive Acquisition Provider
CAPD Continuous Ambulatory Peritoneal Dialysis www.cms.gov
CAP-REL Capital-Related
CBSA Core Based Statistical Areas
CCN CMS Certification Number
CCPD Continuous Cycling Peritoneal Dialysis www.cms.gov
CCU Coronary Care Unit
CFR Code of Federal Regulations www.gpoaccess.gov
CHA California Hospital Association www.calhealth.org
CHPP Center for Health Plans and Providers
CMG Case-mix Groups
CMHC Community Mental Health Center www.cccmha.org/
CMI Case – Mix Index
CMS Centers for Medicare & Medicaid Services www.cms.hhs.gov
COL Column
CORF Comprehensive Outpatient Rehabilitation Facility www.cms.gov
COS Clinical Outcomes Systems
CRNA Certified Registered Nurse Anesthetist www.ehow.com
CRRP Child Care, Resource and Referral Development Program www.cde.ca.gov
CTC Certified Transplant Center www1.cms.gov

D
DEFRA Deficit Reduction Act of 1984
DHCS Department of Health Care Services www.dhcs.ca.gov
DHHS Department of Health and Human Services www.hhs.gov/
DME Durable Medical Equipment
DPP Disproportionate Patient Percentage www.hhs.gov
DRA Deficit Reduction Act of 2005
DRG Diagnostic Related Group
DSH Disproportionate Share – Medicare www.cms.gov

E
EACH Essential Access Community Hospital
ESRD End Stage Renal Disease

F
FCSO First Coast Service Options, Inc. www.fcso.com
FI Fiscal Intermediary
FIM Functional Independence Measure
FQHC Federally Qualified Health Center www.cms.gov
FR Federal Register www.gpoaccess.gov
FRVS Fair Rent Value System
FTE Full Time Equivalent

G
GME Graduate Medical Education www.acgme.org

H
HCFA Health Care Financing Administration www.hhs.gov
HFMA Healthcare Financial Management Association www.hfma.org
HHA Home Health Agency
HHSA State of California – Health and Human Services Agency www.chhs.ca.gov
HIPAA Health Insurance Portability and Accountability Act of 1996 www.cms.gov
HMO Health Maintenance Organization
HSCS Health & Safety Code Sections www.cdph.ca.gov
HSR Hospital Specific Rate
HSRV Hospital-Specific Relative Values

I
I & Rs Interns and Residents www.acgme.org
ICF Intermediate Care Facility
ICF/MR Intermediate Care Facility for the Mentally Retarded (9/96)
ICU Intensive Care Unit
IME Indirect Medical Education www.cms.gov
INPT Inpatient
IPF Inpatient Psychiatric Facility
IRF Inpatient Rehabilitation Facility

J

K

L
LCC Lesser of Reasonable Cost or Customary Charges
LDP Labor, Delivery and Postpartum
LIP Low Income Patient
LOS Length of Stay
LTCH LongTerm Care Hospital
LTCRU Long Term Care Reimbursement Unit
LTCSDU Long Term Care System Development Unit

M
M+C Medicare + Choice (also known as Medicare Part C)
MA Medicare Advantage (previously known as M+C)
MAC Medicare Administrative Contractors
MCP Monthly Capitation Payment
MDH Medicare Dependent Hospital (10/97)
MDS-PAC Minimum Data Set for Past-Acute Care
MEA Medicare Enrollment Application
MED-ED Medical Education
MedPAC Medicare Payment Advisory Commission
MedPAR Medicare Provider Analysis and Review File Tool www.cms.gov
MIPPA Medicare Improvements for Patients and Providers Act of 2008
MIRL Maximum Inpatient Reimbursement Limitation
MMA Medicare Prescription Drug Improvement and Modernization Act of 2003
MPD Medi-Cal Policy Division
MSA Metropolitan Statistical Area (10/97)
MS-DRG Medicare Severity Diagnosis-Related Group
MSP Medicare Secondary Payer

N
NF Nursing Facility
NHCMQ Nursing Home Case Mix and Quality Demonstration www.ncbi.nlm.nih.gov
NPI National Provider Identifier nppes.cms.hhs.gov

O
OBRA Omnibus Budget Reconciliation Act of 1993
OLTC Other Long Term Care
OOT Outpatient Occupational Therapy
OPD Outpatient Department
OPO Organ Procurement Organization www.organdonor.gov
OPPS Outpatient Prospective Payment System
OPT Outpatient Physical Therapy
ORF Outpatient Rehabilitation Facility
OSHPD Office of Statewide Health Planning and Development www.oshpd.cahwnet.gov/
OSP Outpatient Speech Pathology

P
PARD Provider Audit and Reimbursement Department
PBP Provider-Based Physician
PGBA Palmetto GBA www.palmettogba.com
PIRL Peer Group Inpatient Reimbursement Limitation http://files.medi-cal.ca.gov
PM Program Memorandum
PPP Prospective Payment Provider
PPS Prospective Payment System
PRM Provider Reimbursement Manual www.cms.gov
PRO Professional Review Organization
PRS Provider Rate Section
PS&R Provider Statistical and Reimbursement System www.cms.gov
PT Physical Therapy

Q
QAFP Quality Assurance Fee Program

R
RCE Reasonable Compensation Equivalent
RDB Rate Development Branch
RHC Rural Health Clinic www.cms.gov
RHQDAPU Reporting Hospital Quality Data for Annual Payment Update www.cms.gov
RPCH Rural Primary Care Hospitals
RT Respiratory Therapy
RUG Resource Utilization Group

S
SCH Sole Community Hospitals www.cms.gov
SCHIP State Children Health Insurance Program www.cms.gov
SNF Skilled Nursing Facility
SSI Supplemental Security Income (for Long Tern Care Hospital) www.cms.gov
SSI Supplemental Security Income (for Inpatient Rehab Facilities) www.cms.gov

T
TEFRA Tax Equity and Fiscal Responsibility Act of 1982
TOPs Transitional Outpatient Payment System

U
UPIN Unique Physician Identification Number www.hipaaspace.com

V

W
W&ICS Welfare and Institutions Code Sections www.cdph.ca.gov
WKST Worksheet
WPS Wisconsin Physician Services www.wpsic.com

X

Y

Z