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Medicaid and CHIP Payment Advisory Commission

A committee charged with reviewing and making recommendations regarding state and federal payment policies within the Medicaid and CHIP programs.

Medicaid Community-Based Services

States are now allowed to extend full Medicaid coverage to certain home based and community based services (generally covers care for mental or physical disabilities)

Medicaid Crowd-Out

When the availability of Medicaid hurts the market for other insurance products. Generally refers to Medicaid crowding out the long-term care insurance market.

Medicaid Drug Rebate

A rebate paid by participating pharmaceutical companies to Medicaid in exchange for coverage of their products.

Medicaid Expansion

The Affordable Care Act allows states to extend Medicaid benefits to eligible childless adults up to 133% of the federal poverty line.

Medicaid Health Homes

Health care facilities designed to offer comprehensive, on-going care for patients with multiple chronic health conditions.

Medicaid Integrity Institute (MII)

A national Medicaid program integrity training center for States, established by the Centers for Medicare & Medicaid Services in collaboration with the U.S. Department of Justice, Office of Legal Education. The MII focuses on providing training, technical assistance, and support to State Medicaid program integrity employees.

Medicaid Payments for Hospital-Acquired Infections

Prohibits federal funds from being used to pay for treatment of designated hospital-acquired infections.

Medicaid Waivers

Ability of the Secretary of Health and Human Services to allow a state to continue obtaining Medicaid funds when it is no longer compliant with requirements of Medicaid statute. States seek Medicaid waivers when experimenting with innovative services and payment reforms.

Medical Care Evaluation (MCE)

A study of hospital procedures, inpatient data and administrative factors that allow for conclusions about the hospital’s medical care and what needs improvement.

Open Enrollment

Time period during which employees or individual market consumers can change their insurance plans or enroll in new ones.