Glossary

Glossary and Acronyms
Term Sort descending	Definition
MEDICARE PART A (HOSPITAL INSURANCE)	Hospital insurance that pays for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
MEDICARE PART A FISCAL INTERMEDIARY	A Medicare contractor that administers the Medicare Part A (institutional) benefits for a given region.
MEDICARE PART B (MEDICAL INSURANCE)	Medicare medical insurance that helps pay for doctors’ services, outpatient hospital care, durable medical equipment, and some medical services that aren’t covered by Part A.
MEDICARE PART B CARRIER	A Medicare contractor that administers the Medicare Part B (Professional) benefits for a given region.
MEDICARE PART B PREMIUM REDUCTION AMOUNT	Since CY 2003, MCOs are able to use their adjusted excess to reduce the Medicare Part Bpremium for beneficiaries. When offering this benefit, a plan cannot reduce its payment bymore than 125 percent of the Medicare Part B premium. In order to calculate the Part Bpremium reduction amount, the PBP system must multiply the number entered in the "indicateyour MCO plan payment reduction amount, per member" field by 80 percent. The resultingnumber is the Part B premium reduction amount for each member in that particular plan (rounded to the nearest multiple of 10 cents).
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 PREFERRED PROVIDER ORGANIZATION (PPO) PLAN	A type of Medicare Advantage Plan in which you use doctors, hospitals, and providers that belong to the network. You can use doctors, hospitals, and providers outside of the network for an additional cost.
MEDICARE PREMIUM COLLECTION CENTER (MPCC)	The contractor that handles all Medicare direct billing payments for direct billed beneficiaries. MPCC is located in Pittsburgh, Pennsylvania.
MEDICARE PRIVATE FEE-FOR-SERVICE PLAN	A type of Medicare Advantage plan in which you may go to any Medicare-approved doctor or hospital that accepts the plan’s payment. The insurance plan, rather than the Medicare program, decides how much it will pay and what you pay for the services you get. You may pay more or less for Medicare-covered benefits. You may have extra benefits the Original Medicare Plan doesn’t cover.
MEDICARE PROGRAM INTEGRITY MANUAL	Medicare instruction to medical review contractors, which is designed to identify and address fraud, waste, and abuse.