Medicare Glossary

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Term Definition
Medicare Durable Medical Equipment Regional Carrier

A Medicare contractor responsible for administering Durable Medical Equipment (DME) benefits for a region.

Medicare Economic Index

An index often used in the calculation of the increases in the prevailing charge levels that help to determine allowed charges for physician services. In 1992 and later, this index is considered in connection with the update factor for the physician fee schedule.

Medicare Health Support

A Medicare disease management initiative administered by CMS. Section 721 of the Medicare Modernization Act of 2003 (MMA) authorized development and testing of a voluntary chronic care improvement program, now called Medicare Health Support, to improve the quality of care and life for people living with multiple chronic illnesses.

Medicare Medical Savings Account Plan

A Medicare health plan option made up of two parts. One part is a Medicare MSA Health Insurance Policy with a high deductible. The other part is a special savings account where Medicare deposits funds that payments can be made from before the deductible is met.

Medicare Modernization Act

See Medicare Prescription Drug, Improvement and Modernization Act of 2003

Medicare Part A Fiscal Intermediary

A Medicare contractor that administers the Medicare Part A (institutional) benefits for a given region.

Medicare Payment Advisory Commission

A commission established by Congress in the Balanced Budget Act of 1997 to replace the Prospective Payment Assessment Commission and the Physician Payment Review Commission. MedPAC is directed to provide the Congress with advice and recommendations on policies affecting the Medicare program.

Medicare Plus Choice

See Medicare + Choice

Medicare PPO

A demonstration project whereby contracting plans offer PPO benefits to enrolled Medicare beneficiaries, and Medicare pays the plans under modified risk arrangements

Medicare Premium Collection Center

The contractor that handles all Medicare direct billing payments for direct billed beneficiaries. MPCC is located in Pittsburgh, Pennsylvania.

Medicare Premium Support

The concept of premium support builds on the notion of beneficiaries picking private plans to deliver their Medicare benefits, but with an additional feature of limiting the government subsidy and not permitting it to vary with plan features. Beneficiaries would receive a government contribution toward the premium charged by a private plan of their choice. If the premium exceeded the contribution, beneficiaries would pay the difference.

Medicare Prescription Drug Plan

A plan contracted with Medicare to provide Part D benefits to enrolled beneficiaries receiving their medical Medicare benefits through tradtional Medicare, and any supplemental coverage, as opposed to integrated Part D coverage such as provided through Medicare Advantage plans.

Medicare Prescription Drug, Improvement and Modernization Act of 2003

Medicare reform law that created voluntary Part D prescription drug benefits for Medicare Beneficiaries, retitled the Medicare+Choice program as "Medicare Advantage", increased Medicare Advantage payments to participating plans and created Health Savings Accounts (HSAs).

Medicare Remittance Advice Remark Codes

A national administrative code set for providing either claim-level or service-level Medicare-related messages that cannot be expressed with a Claim Adjustment Reason Code. This code set is used in the X12 835 Claim Payment & Remittance Advice transaction, and is maintained by the HCFA.

Medicare Risk HMO

An HMO contracting with under the Medicare Advantage program