AAHAM CRCS STACK 1
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| Who reviews written quality of svc complaints for Medicare and what does the review address? | QIO (Quality Improvement Organization, which is under CMS). Review addresses:
whether svcs provided met professionally recognized standards of HC, if appropriate svcs were provided in appropriate setting.
Results are submitted to the CMS.
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| What is the goal of the QIO? | QIO= Quality Improvement Organization Program:
Under CMS, monitors and improves utilization and quality of care for MC beneficiaries.
There is a national network of QIO's for each state, territory and DC.
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| What does AHA stand for and what is it responsible for? | American Hospital Association
Patient Bill of Rights, which later was replaced by a plain language brochure called the Patient Care Partnership.
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| What does the Patient Care Partnership state? | Expectations that patients and their families can have for treatment during their care.
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| What does OIG stand for and what does it do? | Office of Inspector General
protects the integrity of the HHS programs and the health and welfare of the beneficiaries of these programs.
Play a major role in investigating Fraud and Abuse.
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| What does AAHAM stand for? | American Association of Healthcare Administrative Management.
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| What does CMS stand for and what do they do? | Centers for Medicare and Medicaid Services
Rules & Regs that govern MC & MA.
Oversight of MC program (Title XVIII) and federal portion of MA Program (Title XIX) as well as state CHIP, the health ins marketplace and related quality assurance activities.
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| What are the 2 main governing bodies that affect healthcare change and what department oversees them? | CMS (Centers for Medicare and Medicaid Services)
OIG (Office of Inspector General)
Overseen by: HHS (US Dept of Health and Human Services)
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