Program that identifies management inefficiencies and areas vulnerable to fraud and abuse and to correct such weaknesses with improved internal controls.

Plan that may be used by states to obtain permission to institute managed care programs for their Medicaid or other categorically eligible beneficiaries.

Percentage of federal funds that are available to a state to give Medicaid services. FMAP is annually calculated using a formula that provides a higher federal matching rate to states with lower per capita income. The federal share of Medicaid administrative costs is a flat 50% and is not based on a per capita income formula.

Federal regulations mandate that managed care plans that service federal employees must have an annual open enrollment period of at least 30 days. This allows subscribers either to enroll in, re-enroll, or transfer between health insurance plans. See also open enrollment period, open enrollment , and group enrollment period .

Status (federal classification) defined by the Tax Equity and Fiscal Responsibility Act (TEFRA) that lets a federally qualified health maintenance organization (HMO) or a competitive medical plan (CMP) participate in specific Medicare cost and risk contracts and also receive federal grants and loans. A managed care organization must be a federally qualified or state plan defined to participate in the Medicaid managed care program.

Official daily publication of the federal government that is available online via the Internet. An important function of the Federal Register is its inclusion of proposed changes (e.g., final rules, legal notices and regulations, mandated standards, documents that have general applicability and legal effect) from all federal agencies, as well as executive orders and other presidential documents. HCPCS Level II and ICD-9-CM code standards appear online updated annually for the Medicare program.

1. Facility located in a medically underserved area that provides Medicare beneficiaries preventive primary medical care under the general supervision of a physician. 2. Health center that has been approved by the government for a program to give low-cost health care. Medicare pays for some health services in FQHCs that are not usually covered such as preventive care. FQHCs include community health centers, tribal health clinics, migrant health services, and health centers for the homeless. Also called federally qualified health clinic (FQHC) .