A person born between 1945 and 1964.
Landmark legislation designed to change Medicare reimbursement policies and seek deeper punishment for fraud and abuse. This BBA also established a standard prospective payment system (PPS) for nursing home and home health agencies.
A revision to the BBA that, among other things, provided a temporary increase in payment for certain high-costs patients, increases federal per diem PPS of Medicare patients, and increases the federal rates for all categories of patients. The agreement also permits skilled nursing facilities to choose to receive Medicare payments based 100% on the federal per diem rate rather than partially on a federal per diem rate and partially on a pre-PPS facility-specific rate.
See Balanced Budget Act
A benefit that pays a provider (such as nursing home, assisted living facility or hospice facility) to hold an individual’s bed during a temporary absence so that the beneficiary may return to the facility.
Bed sores -- see pressure ulcers
To be bedridden.
The individual to receive benefits provided by an insurance program (including Medicare and Medicaid).
The amount of time an insurance company will make payments to the individual to pay for care, etc after a deductible has been satisfied.
Specific situations that start payment of benefits.
Money paid by an insurance program to the beneficiary, or his care provider.
A combination of the federal PPS reimbursement rate and the facility-specific rate.
Also called “adult care home” or “group home.” A residence that offers housing and personal care services for three to 16 residents. Services (such as meals, supervision and transportation) are usually provided by the owner or manager. May be a single-family home (licensed as “adult family home” or “adult group home”).
Using one, all-inclusive payment for a variety of interrelated services.