Lec 3 Flashcards
Federal agency that
-administers health-related
programs
-Works in partnership with the states to administer
Medicaid, the Children’s Health Insurance Program , and the Health Insurance Portability and
Accountability Act
-Develops Conditions of Participation (COPs) that
should be met to participate in the Medicare and
Medicaid programs
CENTERS FOR MEDICARE AND MEDICAID
SERVICES
Philippine Counterpart of CMS
PhilHealth
PhilHealth Republic Act No.
10606 of 2012
assumed the responsibility of
administering the former Medicare program for
government and private sector employees
PhilHealth
health insurance policy offered to the
senior-citizen set, along with people under 65
who have certain disabilities
MEDICARE
a public assistance program based largely on
financial need; it’s paid for with public funds
collected through taxes
MEDICAID
insurance program that provides low-cost
health coverage to children in families that
earn too much money to qualify for
Medicaid but not enough to buy private
insurance
Children’s Health Insurance Program (CHIP)
federal law that required the creation of
national standards to protect sensitive patient
health information from being disclosed
without the patient’s consent or knowledge
○ Privacy protection
Health Insurance Portability and Accountability
Act (HIPAA)
acknowledges that a hospital or other health care
organization has met or exceeded the requirements
of an accrediting body
ACCREDITATION
an independent, not-for-profit organization
dedicated to improving the safety and quality of
health care in organized health care settings
THE JOINT COMMISSION INTERNATIONAL
sets continually evolving standards for acute care
hospitals and other health care organizations
THE JOINT COMMISSION INTERNATIONAL
Accredits the hospital based on safety,
processes,documentation, and equipments
THE JOINT COMMISSION INTERNATIONAL
JCI developed _______________________ that address specific patient safety issues, some are
medication related, and accreditation is valid for _________
National Patient Safety Goals (NPSGs); three years
JCI Accredited Hospitals
Asian Hospital and Medical Center
St. Luke’s Medical Center
The Medical City
Makati Medical Center
principal accreditation agency for osteopathic
medical colleges and health care facilities, address all departments and functions including
pharmacy services and medication use
HEALTHCARE FACILITIES ACCREDITATION
PROGRAM (HFAP)
HFAP accreditation is valid for
three years
integrates CMS CoPs with ISO 9001 Standards
(global principles designed to provide assurance that
quality in imbedded in supplier-customer
relationships)
NATIONAL INTEGRATED ACCREDITATION FOR
HEALTHCARE ORGANIZATIONS (NIAHO)
ISO stands for
International Organization for
Standardization
designed to facilitate the development and
implementation of a Quality Management System
(QMS) for health care organization
NIAHO
NIAHO accreditation is valid for
three years
