Healthcare Laws

Question 1

FELA

Answer 1

1908 Federal Employees Liability Act Compensates railroad workers

Question 2

FECA

Answer 2

1916 Federal Employees Compensation Act - provides federal employees with medical care, survivors benefits

Question 3

Hill Burton Act

Answer 3

Government grant to modernize hospital. Hospital provide care to people who can’t afford

Question 4

Taft Hartley Act

Answer 4

1947 - amended the national labor relations act of 1932 balanced labor and management power created third party administrators/ health plans

Question 5

ICD

Answer 5

1948 World Health Organization develops International Classification of Diseases (ICD)

Question 6

Major Medical Insurance

Answer 6

1950 major medical insurance, prolonged health conditions, deductible- patient payment, lifetime maximum

Question 7

Medicare Medicaid

Answer 7

1966 Medicare(Title XVIII) for seniors over 65
Medicaid (Title XIX)for low income

Question 8

CHAMPUS

Answer 8

1966 Civilian Health and Medical Program-Uniformed Services for dependents of personnel serving in the armed forces, National Oceanic and Atmospheric Administration. Now Tricare

Question 9

Self-insured group health plans

Answer 9

1970 self insured employer-sponsored group health plans

Question 10

CHAMPVA

Answer 10

1973 Civilian Health and Medical Program of the Department of Veterans Affairs health care benefits for dependantsof vetrans totally disabled

Question 11

ERISA

Answer 11

1974 Employee Retirement Income Security Act Large employers exempt from taxes on Healthcare on premium co-pays and coinsurance

Question 12

OBRA

Answer 12

1981 Omnibus Budget Reconciliation Act expanded Medicare and Medicaid

Question 13

DRG

Answer 13

1983 Tax Equity and Fiscal Responsibility Act of 1982 created Medicare HMO plans that met specified Medicare requirements to provides Medicare-covered services under a risk contract. prospective payment system PPS predetermined payment for inpatient services. Per diem basis before. Diagnosis-related groups DRGs

Question 14

HCFA-1500

Answer 14

1984 now called CMS-1500 Form to submit Medicare claims. The HCFA Common Procedure Coding System (HCPCS) now Healthcare not HCFA

Question 15

COBRA

Answer 15

1985 Consolidated Omnibus Budget Reconciliation Act of 1985 employees to continue coverage plan beyond term date

Question 16

TRICARE

Answer 16

1988 Champus Reform Initiative (CRI) TricarePrime, Extra, Standard

Question 17

CLIA

Answer 17

1988 Clinical Labratory Improvement Act established quality standard for all laboratory testing. Medicare Catastrophic Coverage Act reporting ICD codes on MEDICARE claims

Question 18

CPT E/M Codes

Answer 18

CMS Implemented revisions of the CPT and adds the Evaluation/Management describes encounters w/ physician for general health status

Question 19

RBVS

Answer 19

1992 Resource based Relative Value Scale new fee schedule for Medicare services and replaces old systems. Reimburse physicians based on their work, practice expense, malpractice expense.

Question 20

NCCI

Answer 20

1996 National correct Coding initiative created to reduce coding errors AMA/CPT Manual