Healthcare Laws Flashcards
Laws
FELA
1908 Federal Employees Liability Act Compensates railroad workers
FECA
1916 Federal Employees Compensation Act - provides federal employees with medical care, survivors benefits
Hill Burton Act
Government grant to modernize hospital. Hospital provide care to people who can’t afford
Taft Hartley Act
1947 - amended the national labor relations act of 1932 balanced labor and management power created third party administrators/ health plans
ICD
1948 World Health Organization develops International Classification of Diseases (ICD)
Major Medical Insurance
1950 major medical insurance, prolonged health conditions, deductible- patient payment, lifetime maximum
Medicare Medicaid
1966 Medicare(Title XVIII) for seniors over 65 Medicaid (Title XIX)for low income
CHAMPUS
1966 Civilian Health and Medical Program-Uniformed Services for dependents of personnel serving in the armed forces, National Oceanic and Atmospheric Administration. Now Tricare
Self-insured group health plans
1970 self insured employer-sponsored group health plans
CHAMPVA
1973 Civilian Health and Medical Program of the Department of Veterans Affairs health care benefits for dependantsof vetrans totally disabled
ERISA
1974 Employee Retirement Income Security Act Large employers exempt from taxes on Healthcare on premium co-pays and coinsurance
OBRA
1981 Omnibus Budget Reconciliation Act expanded Medicare and Medicaid
DRG
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
HCFA-1500
1984 now called CMS-1500 Form to submit Medicare claims. The HCFA Common Procedure Coding System (HCPCS) now Healthcare not HCFA
COBRA
1985 Consolidated Omnibus Budget Reconciliation Act of 1985 employees to continue coverage plan beyond term date
TRICARE
1988 Champus Reform Initiative (CRI) TricarePrime, Extra, Standard
CLIA
1988 Clinical Labratory Improvement Act established quality standard for all laboratory testing. Medicare Catastrophic Coverage Act reporting ICD codes on MEDICARE claims
CPT E/M Codes
CMS Implemented revisions of the CPT and adds the Evaluation/Management describes encounters w/ physician for general health status
RBVS
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.
NCCI
1996 National correct Coding initiative created to reduce coding errors AMA/CPT Manual
