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MMA 2003

Glossary

This glossary explains terms in the Medicare program, but it is not a legal document. The official Medicare program provisions are found in the relevant laws, regulations, and rulings.

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A B C D E F G H I J K L M
 
N O P Q R S T U V W X Y Z


Term Definition
NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA)

A non-profit organization that accredits and measures the quality of care in Medicare health plans. NCQA does this by using the Health Employer Data and Information Set (HEDIS) data reporting system. (See Health Employer Data and Information Set (HEDIS).)

NATIONAL MEDIAN CHARGE

The national median charge is the exact middle amount of the amounts charged for the same service. This means that half of the hospitals and community mental health centers charged more than this amount and the other half charged less than this amount for the same service.

NEGLECT

When care takers do not give a person they care for the goods or services needed to avoid harm or illness.

NETWORK

A group of doctors, hospitals, pharmacies, and other health care experts hired by a health plan to take care of its members.

NO-FAULT INSURANCE

No-fault insurance is insurance that pays for health care services resulting from bodily injury or damage to your property regardless of who is at fault for causing the accident.

NON-FORMULARY DRUGS

Drugs not on a plan-approved list.

NONPARTICIPATING PHYSICIAN

A doctor or supplier who does not accept assignment on all Medicare claims. (See Assignment.)

NOTICE OF MEDICARE BENEFITS

A notice you get to show what action was taken on a claim. (See Explanation of Medicare Benefits; Medicare Benefits Notice; Medicare Summary Notice.)

NOTICE OF MEDICARE PREMIUM PAYMENT DUE - HCFA 500

The billing notice sent to Medicare beneficiaries who must pay their Medicare premium directly. Notices are sent either monthly or quarterly.

NURSE PRACTITIONER (NP)

A nurse who has 2 or more years of advanced training and has passed a special exam. A nurse practitioner often works with a doctor and can do some of the things a doctor does.

NURSING HOME

A residence that provides a room, meals, and help with activities of daily living and recreation. Generally, nursing home residents have physical or mental problems that keep them from living on their own. They usually require daily assistance.

NUTRITION

Getting enough of the right foods with vitamins and minerals a body needs to stay healthy. Malnutrition, or the lack of proper nutrition, can be a serious problem for older people.

*NOTE: An asterisk (*) after a term means that this definition, in whole or in part, is used with permission from Walter Feldesman, ESQ., Dictionary of Eldercare Terminology, Copyright 2000.

This glossary explains terms in the Medicare program, but it is not a legal document. The official Medicare program provisions are found in the relevant laws, regulations,and rulings.
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Date Last Updated: September 23, 2004

 

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