Greatest amount an insurance carrier will pay for a specific benefit or policy during a specified time period.

Federal legislation (Public Law 15) enacted in 1945 providing that even though the insuring or provision of health care may be national in scope, the regulation of insurance is left to the states. Under the Act, insurance is exempt from some federal antitrust statutes to the extent that it is regulated by the states. The exemption primarily applies to gathering data in concert for the purpose of ratemaking. Otherwise, antitrust laws prohibit insurers from boycotting, acting coercively, restraining trade, or violating the Sherman or Clayton Acts.
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Passed by Congress in 1945, this act states that regulation and taxation of insurance by the states is in the public interest and that congressional silence should not be construed as a barrier to state regulation.

1. Acronym that means a Doctor of Medicine degree. See medical doctor (MD) . 2. See Doctor of Osteopathy (DO) .

Abbreviation for medical-surgical. See medical-surgical nursing and medical-surgical procedures .

Reference medical terminology classification system created by the National Committee on Vital Health and Statistics that is used to code text data after they are captured by an electronic health record (EHR) system. It assists in the standardization of clinical point of care terminology used in EHRs.

California’s version of the nationwide program known as Medicaid . See Medicaid (MCD) .

Sometimes referred to as a Care/Caid case . See Medicare/Medicaid (Medi-Medi) . Also see crossover patient .

Medical assistance program established in 1965 by Title XIX of the Social Security Act that is jointly funded by the federal government and the states. It provides medical benefits for certain low-income persons in need of health and medical care. Recipients’ benefits, data for claims processing, and payments vary from state to state. Medicaid is jointly funded by the federal and state governments to assist states in providing long-term care assistance to people who meet certain eligibility criteria. California’s Medicaid program is known as Medi-Cal .