Performance of an unlawful, wrongful act.

Abnormal growth that has the properties of invasion and metastasis (i.e., transfer of diseases from one organ to another). The word “carcinoma” (CA) refers to a cancerous or malignant tumor.

To deliberately pretend or fake symptoms of a disease or injury to intentionally profit in some way to reach a desired end (collect insurance benefits) or to feign symptoms as the result of mental illness.
***
US: The practice of feigning illness or inability to work in order to collect insurance benefits.
***
To feign a disability for the purpose of continuing to collect benefits longer than actually necessary.

Health problem caused by the lack of, or too much, needed nutrients.

One of three components used in determining the relative value units under the resource-based relative value scale. Malpractice costs stand for the cost of professional liability insurance for each procedure.

Cost of professional liability insurance coverage incurred by a physician.

Effort to lower costs in health care by reducing the number of lawsuits against physicians and other health care providers and/or the amounts awarded in such lawsuits.

Special x-ray of the breasts. Medicare covers the cost of a mammogram once a year for women older than age 40.

Program in a managed care organization (MCO) under a carve-out arrangement that provides services to the members such as behavioral services, utilization management services, or organizing an employee assistance program (EAP).

MEDICAL,USA: 1. System of health care delivery designed to reduce unnecessary utilization of medical services, control costs, and measure performance while managing access and giving quality, cost-effective health care. Emphasis is placed on prevention, early intervention, and outpatient care. A variety of arrangements for health care delivery and financing includes health maintenance organizations (HMOs), preferred provider organizations (PPOs), point-of-service (POS) plans, and competitive medical plans (CMPs). The plans provide health services on prepayment terms that are based on either cost or risk. 2. Reimbursement method by third-party payers who implement some requirements to control costs of health care while retaining quality care. 3. Under Medicare, includes HMOs, CMPs, and other plans that provide health services on prepayment terms, which are based on either cost or risk, depending on the type of contract they have with Medicare. The term managed care has been replaced with Senior Advantage plans . See also Medicare Plus (+) Choice (M+C) program and Senior Advantage plans . Also called managed health care .
***
US: Health care systems that integrate the financing and delivery of appropriate health care services to covered individuals by arrangements with selected providers to furnish a comprehensive set of health care services, explicit standards for selection of health care providers, formal programs for ongoing quality assurance and utilization review, and significant financial incentives for members to use providers and procedures associated with the plan.22424
***
Systems designed to integrate the delivery and financing of health care of the highest possible quality at the lowest possible cost. In contrast to traditional fee for service arrangements, under managed care, health providers ,1. agree to negotiated payment levels for specified services to defined patient populations ,2. agree to more aggressive utilization and quality assurance review and ,3. assume financial risk leading to more severe restriction on patient choice to obtain services outside the network.