Glossary

A portion of the hospital where emergency diagnosis and treatment of illness or injury is provided.

For purposes of the Medicare Secondary Payer (MSP) provisions, an employee is an individual who works for an employer, whether on a full- or part-time basis, and receives payment for his/her work.

Individuals and organizations engaged in a trade or business, plus entities exempt from income tax such as religious, charitable, and educational institutions, the governments of the United States, Puerto Rico, the Virgin Islands, Guam, American Samoa, the Northern Mariana Islands, and the District of Columbia, and the agencies, instrumentalities, and political subdivisions of these governments.

An electronic bulletin board service offered by the COB Contractor. Employers that have to report on less than 500 workers can fulfill their requirements under the Internal Revenue Service/Social Security Administration/Health Care Financing Administration (IRS/SSA/HCFA) Data Match law by downloading a questionnaire entry application from the bulletin board. The information will be processed through several logic and consistency edits. Once the employer has completed the information, he or she will return the completed file through the bulletin board.

A GHP is a health plan that:

• Gives health coverage to employees, former employees, and their families, and
• Is from an employer or employee organization.

A standard adopted by the Secretary of HHS to identify employers in standard transactions. The IRS’ EIN is the adopted standard.

The EMT-Basic has the knowledge and skills of the First Responder but is also qualified to function as minimum staff for an ambulance. Example: At the scene of a cardiac arrest, the EMT-Basic would be expected to defibrillate and ventilate the patient with a manually operated device and supplemental oxygen.

The EMT-Intermediate has the knowledge and skills of the First Responder and EMT-Basic, but in addition can perform essential advanced techniques and administer a limited number of medications. Example: At the scene of a cardiac arrest, the EMT-Intermediate would be expected to intubate and administer first line Advanced Cardiac Life Support (ACLS) medications.

The EMT-Paramedic has demonstrated the compentencies expected of a Level 3 (EMT-Intermediate) provider, but can administer additional interventions and medications. Example: At the scene of a cardiac arrest, the EMT-Paramedic might administer second line Advanced Cardiac Life Support (ACLS) medications and use an external pacemaker.

The Emergency Medical Treatment and Active Labor Act, codified at 42 U.S.C. § 1395dd. EMTALA requires any Medicare-participating hospital that operates a hospital emergency department to provide an appropriate medical screening examination to any patient that requests such an examination. If the hospital determines that the patient has an emergency medical condition, it must either stabilize the patient's condition or arrange for a transfer; however, the hospital may only transfer the patient if the medical benefits of the transfer outweigh the risks or if the patient requests the transfer. CMS regulations at 42 C.F.R. §§ 489.24(b) and 413.65(g) further clarify the statutory language.