Abbreviations and References

Abbreviations and References
 
BBA—Balanced Budget Act of 1997

CCO—coordinated care organization

CFR—Code of Federal Regulations

CMR—Compliance Monitoring Review

CMS—Centers for Medicare & Medicaid Services

DCO—dental care organization

DSN—delivery system network

EQR—external quality review

EQRO—external quality review organization

HSAG—Health Services Advisory Group, Inc.

ISCA—Information Systems Capabilities Assessment

MCE—managed care entity (includes CCOs, DCOs, and an MHO)

MCO—managed care organization

MHO—mental health organization

NAV—validation of network adequacy

OARs—Oregon Administrative Rules

OHA—Oregon Health Authority

PAHP—prepaid ambulatory health plan

PIHP—prepaid inpatient health plan

PIP—performance improvement project

PMV—performance measure validation

PSV—primary source verification

QAPI—quality assessment and performance improvement

References used in this website:

42 CFR Part 438 Managed Care. Available at: https://www.gpo.gov/fdsys/pkg/CFR-2002-title42-vol1/content-detail.html. Accessed on: November 30, 2018.

Department of Health and Human Services, Centers for Medicare & Medicaid Services. EQR Protocols. Version 2.0, September 2012. Available at: https://www.medicaid.gov/medicaid/quality-of-care/medicaid-managed-care/external-quality-review/index.html. Accessed on: November 30, 2018.