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ABMS | American Board of Medical Specialties is a not-for-profit organization that assists the 24 approved medical specialty boards in the development and use of standards in the ongoing evaluation and certification of physicians. More information is available here: https://www.abms.org/ |
CIA | OIG negotiates corporate integrity agreements (CIA) with healthcare providers and other entities as part of the settlement of Federal healthcare program investigations arising under a variety of civil false claims statutes. Providers or entities agree to the obligations, and in exchange, OIG agrees not to seek their exclusion from participation in Medicare, Medicaid, or other Federal health care programs. See the Office of Inspector General’s webpage here: https://oig.hhs.gov/compliance/corporate-integrity-agreements/index.asp |
CMP | Civil Monetary Penalties (CMP) may be levied by the OIG on entities and individuals for certain conduct. In most cases, the OIG can also seek exclusion from participation in all Federal health care programs. See the Office of Inspector General’s webpage here: https://oig.hhs.gov/fraud/enforcement/about/ |
CMS | The Centers for Medicare and Medicaid Services (CMS) is a branch of the U.S. Department of Health and Human Services. CMS is a federal agency that administers Medicare, Medicaid, and The Children’s Health Insurance Program. More information is available here: https://www.cms.gov/about-cms |
CRA | Short for “consumer reporting agency,” which is defined by § 603(f) of the Fair Credit Reporting Act as “any person which, for monetary fees, dues, or on a cooperative nonprofit basis, regularly engages in whole or in part in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer reports to third parties, and which uses any means or facility of interstate commerce for the purpose of preparing or furnishing consumer reports.” HireRight is a consumer reporting agency. |
CORI | Massachusetts Criminal Offender Record Information, made available to registered and authorized recipients through the Massachusetts iCORI system. More information can be found here: https://www.mass.gov/massachusetts-criminal-offender-record-information-cori |
HIPAA | Health Insurance Portability and Accountability Act of 1996. The Privacy Rule sets forth certain protections for and gives individuals certain rights related to covered health information. The Security Rule contains security requirements for electronic health information. More information is available here: https://www.hhs.gov/hipaa/index.html |
ICHAT | The Internet Criminal History Access Tool, which allows the search of public criminal records maintained by the Michigan State Police Criminal Justice Information Center. More information is available here: https://www.michigan.gov/msp/services/chr |
The Joint Commission | The Joint Commission is a non-profit that accredits and certifies healthcare organizations in the U.S. More information is available here: https://www.jointcommission.org/ |
LEIE | OIG’s List of Excluded Individuals/Entities provides information to the healthcare industry, patients, and the public regarding individuals and entities excluded from participation in Medicare, Medicaid, and all other federal healthcare programs. More information is available here: https://oig.hhs.gov/faqs/exclusions-faq/ |
MRO | Medical Review Officer. MROs review and evaluate laboratory results associated with an employer’s federal and workplace drug testing program. This helps ensure the accuracy and integrity of all test results. When the lab reports a confirmed positive result, the MRO will try to contact the donor to interview to determine whether there is a reasonable medical explanation for the confirmed results. If there is, the MRO will ask the donor to provide the required verifiable proof and will report the results to the employer. |
NPI | The National Provider Identifier (NPI) is a unique identifier assigned to covered healthcare providers in the United States. |
NPDB | The National Practitioner Data Bank (NPDB) is a national repository used to collect and release, to authorized entities, certain information related adverse action reports, medical malpractice payment reports, and judgement or conviction reports. |
OIG | The Department of Health and Human Services Office of the Inspector General. It is dedicated to combating fraud, waste, and abuse in Medicare, Medicaid, and other HHS programs. More information is available here: https://oig.hhs.gov/about-oig/ |
PATCH | The Pennsylvania Access to Criminal History system is a repository that was created and is maintained in accordance with Pennsylvania's Criminal History Information Act. This Act mandates the Pennsylvania State Police (PSP) to share criminal history data with criminal justice agencies, non-criminal justice agencies, and individuals upon request. More information is available here: https://epatch.pa.gov/home |
PPACA | The Patient Protection and Affordable Care Act is a federal statute signed into law on March 23, 2010. The law aims to make health insurance more widely available and affordable and to expand Medicaid. More information is available here: https://www.hhs.gov/healthcare/about-the-aca/index.html |
SAM | The System for Award Management (SAM) is an official U.S. federal government website that, in part, is used to verify individuals or entities are not excluded parties. More information is available here: https://sam.gov/about/this-site |
URAC | URAC, an independent, nonprofit organization, promotes healthcare quality through its accreditation and certification programs. |