Chapter 4

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FEHBP federal employees health benefit program
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and employer sponsored health insurance program available to employees of the federal government
workers compensation
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a program that provides health care benefits two employees who are injured on the job
Medicare
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a federal program that Pays healthcare costs for the elderly permanently disabled and those with end-stage renal disease
CMS center for Medicare and Medicaid services
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the federal agency that administers the Medicare and Medicaid programs
self-referral /kickbacks
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health care providers are prohibited under federal law from referring patients 2 Laboratories or other health services in which they have a financial interest. Stark law 1
TRICARE
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A Health insurance program offered by the department of Defense to military personnel
Medicare A
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pays for inpatient Hospital services critical access hospitals and skilled nursing facilities
Medicare B
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Physician Services, outpatient hospital care, and some services
SCHTP
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Federal program that targets low-income children whose parents do not qualify for Medicaid and unable for private insurance
Medicaid funding
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funded by taxpayer income tax payments to the government's General Revenue
Medicaid spending distribution
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state uses FMAP
medical coding
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offices use this to determine how much to charge a patient
upcoding
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submitting a claim they never did or a different code at a higher rate
OPM office of personnel management
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human resources department of federal government
Medicare eligibility
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has to be 65 years or older, permanently disabled or end stage renal disease
what is the basic or primary purpose of workers compensation
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provides health care benefits to employees who are injured and eliminate the need for an employee to sue employer

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