Glossary

The administrative governing body of the ESRD Network and liaison to the Federal Government.

A person with irreversible and permanent kidney failure who requires a regular course of dialysis or kidney transplantation to maintain life.

The type of care or service furnished to an ESRD patient. Such types of care are transplantation; dialysis; outpatient dialysis; staff assisted dialysis; home dialysis; and self-dialysis and home dialysis training.

Signs that something is true or not true. Doctors can use published studies as evidence that a treatment works or does not work.

Proof that sufficient funds are available for completion of the project. Usually a copy of the face sheet of the grant, contract, or cooperative agreement is sufficient.

If you are in the Original Medicare Plan, this is the difference between a doctor’s or other health care provider’s actual charge (which may be limited by Medicare or the state) and the Medicare-approved payment amount.

Items or services that Medicare does not cover, such as most prescription drugs, long-term care, and custodial care in a nursing or private home.

A Medicare+Choice organization's second look at whether it will provide a health service. A beneficiary may receive a fast decision within 72 hours when life, health or ability to regain function may be jeopardized.

A fast decision from the Medicare+Choice organization about whether it will provide a health service. A beneficiary may receive a fast decision within 72 hours when life, health or ability to regain function may be jeopardized.

The issuance of checks, disbursement of cash, or electronic transfer of funds made to liquidate an expense regardless of the fiscal year the service was provided or the expense was incurred. When used in the discussion of the Medicaid program, expenditures refer to funds spent as reported by the States. The same as an Outlay.