Category: F

In the Federal budget, a means of presenting budget authority, outlay, and tax expenditure data in terms of the principal purposes which Federal programs are intended to serve. Each specific account is generally placed in the single function (e.g., national defense, health) that best represents its major purpose, regardless of the agency administering the program.…

Neighborhood clinics or health programs which provide medical services in relatively informal settings and styles to, generally, students, transient youth, and minority groups. Care is given at no or nominal charge by predominantly volunteer staffs. The first such clinic is considered to be the Haight-Ashbury Free Clinic, organized in San Francisco in the summer of…

Intentional misrepresentation by either providers or consumers to obtain services, obtain payment for services, or claim program eligibility. Fraud may include the receipt of services which are obtained through deliberate misrepresentation of need or eligibility ; providing false information concerning costs or conditions to obtain reimbursement or certification; or churning payment for services which were…

The practice of charging separately for several services or components of a service which were previously subject to a single charge or not charged for at all. The usual effect is that the total charge is increased. The practice is most commonly seen as a response to limiting increases in the charge which is fractionated.…

A listing of drugs, usually by their generic names, A formulary is intended to include a sufficient range of medicines to enable physicians or dentists to prescribe medically appropriate treatment for all reasonably common illnesses. A hospital formulary normally lists all the drugs routinely stocked by the hospital pharmacy. Substitution of a chemically equivalent drug…

A physician who graduated from a medical school outside of the United States and, usually, Canada. U.S. citizens who go to medical school outside this country are classified as foreign medical graduates (sometimes distinguished as USFMGs), just as are foreign-born persons who are not trained in a medical school in this country, although native Americans…

A single inclusive maternity benefit for all charges incurred as a result of pregnancy, childbirth, and complications arising therefrom. A limit (such as $1,000) may be applied per pregnancy or per year.  

A contractor that processes and pays provider claims on behalf of a State Medicaid agency. Fiscal agents are rarely at risk, but rather serve as an administrative unit for the State, handling the payment of bills. Fiscal agents may be insurance companies, management firms, or other private contractors. Medicaid fiscal agents are sometimes also Medicare…

Coverage under an insurance policy which begins with the first dollar of expense incurred by the insured for the covered benefits. Such coverage, therefore, has no deductibles although it may have copayments or coinsurance. A type of medical insurance in which all costs of care are reimbursed by the insurer, without copayments, deductibles, or other…

One of the several ways that an individual who obtains all or part of his undergraduate medical education abroad can enter graduate medical education in the United States. The fifth pathway provides a period of supervised clinical training to students who obtained their premedical education in the United States, received undergraduate medical education abroad, and…