HCCA Compliance Vocab

2 Midnight Rule correct answer: Regulation included in the 2014 Medicare inpatient prospective payment rule. Established that inpatient admissions spanning at least two midnights qualify for Medicare Part A payments. Inpatient stays lasting fewer than two midnights must be treated and billed as outpatient services. 340B Pricing Program correct answer: A federal program requiring drug manufacturers to provide outpatient drugs to eligible health care organizations/covered entities at significantly reduced prices. Academic Research Organization (ARO) correct answer: An academic institution that performs or manages clinical research services usually by partnering with a research sponsor. Adjusted Average per Capita Cost (AAPCC) correct answer: CMS/HCFA's best estimate for the amount of money it costs to care for Medicare recipients under fee-for-services Medicare in a given area. The AAPCC is made up of 142 different rate cells; 140 of them are factored for age, sex, Medicaid eligibility, Institutional status, working ages, and whether a person has both Part A and Part B of Medicare. The 2 remaining cells are for individuals with end stage renal disease. Adjusted Community Rate (ACR) correct answer: Under the ACA, insurers can't raise premiums based on health status, medical claims, gender, or most of the other factors that they had previously used to determine rates prior to ACA implementation. Advance Beneficiary Notice (ABN) correct answer: A waiver signed by a patient confirming the patient's understanding that certain provided services may not be reimbursable under Medicare and therefore are the patient's responsibility. Advanced Medical Technology Association (Advamed) correct answer: Medical device trade association. Adverse Drug Experience (ADE) correct answer: Any adverse event associated with the use of a drug in humans, whether or not considered drug-related, including the following: An adverse event occurring in the course of the use of a drug product in professional practice; an adverse event occurring from drug overdose whether accidental or intentional; an adverse event occurring from drug abuse; an adverse event occurring from drug withdrawal; and any failure of expected pharmacological action. Adverse Drug Reaction (ADR) correct answer: Injury caused by taking a medication. Adverse Event (Research) (AE) correct answer: Used broadly to mean any untoward or unfavorable medical occurrence in a human subject, including any abnormal sign, symptom, or disease, temporally associated with the subject's participation in research, whether or not considered related to the subject's participation in the resea