Pre-existing Condition

Pre-existing Condition

Concept of Pre-existing Condition in Health Care Law

In this context, a meaning of Pre-existing Condition is the following one: An illness or medical condition, that existed prior to your applying for a health plan, whether or not any medical advice or treatment was recommended or received. The Affordable Care Act prohibits health plans from imposing any pre-existing condition exclusions for plan and policy years beginning after September 23, 2010, for children under 19, and for all others beginning in 2014.

Telemedicine

Telemedicine

Telemedicine in Health Care

Telemedicine involves the use of electronic communication and information technologies to provide or support clinical care at a distance. (Peter R. Kongstvedt, Glossary of Terms and Acronyms, in Essentials of Managed Health Care).

Independent Practice

Independent Practice

Independent Practice Association (IPA) in Health Care

IPAs are networks of independent physicians that contract with MCOs and employers. IPAs may be organized as sole proprietorships, partnerships, or professional corporations. (Peter R. Kongstvedt, Glossary of Terms and Acronyms, in Essentials of Managed Health Care).

Laws

Laws

Any Willing Provider Laws in Health Care

Any willing provider laws take many different forms, but they typically restrict the ability of managed-care organizations to use a closed panel of physicians, hospitals, or other providers. (Peter R. Kongstvedt, Glossary of Terms and Acronyms, in Essentials of Managed Health Care).

Effectiveness

Effectiveness

Concept of Comparative Effectiveness Research in Health Care Law

In this context, a meaning of Comparative Effectiveness Research is the following one: Research that is federally sponsored to compare existing health care interventions to determine which works best for certain patients and which pose the greatest benefits and harms. The research also aims to improve the quality of care and to control costs.

Medicare Contractor

Medicare Contractor

Concept of Medicare Contractor in Health Law

In this context, a short definition of Medicare Contractor is provided here: A Medicare Part A Fiscal Intermediary (institutional), a Medicare Part B Carrier (professional), or a Medicare Durable Medical Equipment Regional Carrier (DMERC)

Specialty Hospital

Specialty Hospital

Single Specialty Hospital (SSH) in Health Care

Specialized hospitals that provide treatment relating to a single specialty (e.g., cardiac or orthopedic services). Many of the physicians who refer patients to an SSH have an ownership interest in the facility. (Peter R. Kongstvedt, Glossary of Terms and Acronyms, in Essentials of Managed Health Care).

Trading Partner

Trading Partner

Concept of Trading Partner in Health Law

In this context, a short definition of Trading Partner is provided here: External entity with whom business is conducted, i.e. customer. This relationship can be formalized via a trading partner agreement. (Note: a trading partner of an entity for some purposes, may be a business associate of that same entity for other purposes.)