Tuesday, January 20
Recurrent Disability Provision
A provision in some insurance plans that continues disability payments if an employee attempts to return to work but is unable to because of their disability. For example, if a worker injures their back and has to take disability leave, recurrent disability provisions would allow them to try to go back to work, and if they find that they have not yet sufficiently healed, they can go back on disability leave and continue to receive payments - including those from the period they attempted to work.
Friday, January 16
Platinum Plan
The highest actuarial level health plans available through the insurance exchanges, equal to a 90 percent actuarial value. Bronze, Silver, and Gold plans offer lower actuarial values.
Thursday, January 15
Utilization Review (UR)
Refers to the evaluation of the efficiency and need of health care services, including procedures and facilities, according to established criteria of the provisions of the health care benefits plan.
Wednesday, January 14
Silver Plan
The second lowest actuarial level health plans available through the insurance exchanges, equal to a 70 percent actuarial value. An individual’s subsidy is based on the second lowest cost silver plan in their region. Bronze, Gold, and Platinum plans offer varying actuarial values.
Tuesday, January 13
Open Enrollment
Time period during which employees or individual market consumers can change their insurance plans or enroll in new ones.
Monday, January 12
Discharge Planning
Process through which insurance providers and health care professionals plan for a patient’s needs after discharge from a care facility.
Friday, January 9
Exchange-eligible Employer
Employers allowed to purchase employee coverage through state health care exchanges.
Thursday, January 8
Sustainable Growth Rate (SGR)
A target growth rate for Medicare spending enacted by law in 1997 that, if exceeded, is supposed to trigger physician payment cuts. The SGR-triggered cuts are continuously delayed and “pushed back” year after year.
Wednesday, January 7
Maintenance Medication
Pharmaceuticals prescribed for ongoing use in the treatment of chronic conditions. Examples include asthma medication or diabetes supplies.
Tuesday, January 6
Episode Payment
Refers to a single price for all of the services needed by a patient for an entire episode of care.