PART 400—INTRODUCTION; DEFINITIONS Authority: 42 U.S.C. 1302 and 1395hh and 44 U.S.C. Chapter 35. Subpart A [Reserved] Subpart B—Definitions § 400.200 General definitions. In this chapter, unless the context indicates otherwise— Act Administrator ALJ Area Beneficiary CMP Conditions of participation requirements for participation Condition level CORF CFR CMS CY DAB Department ESRD FDA FQHC FR Federal Register. FY HCPP HHS HHA HMO ICF ICF/IID Medicaid Medicare Medicare Savings Programs NCD OASDI OIG Public Health Emergency (PHE) QDWI QIO QMB Qualified Disabled and Working Individual (1) Is eligible to enroll for Medicare Part A under section 1818A of the Act. (2) Has income, as determined in accordance with SSI methodologies, that does not exceed 200 percent of the Federal poverty guidelines (as defined and revised annually by the Office of Management and Budget) for a family of the size of the individual's family; (3) Has resources, as determined in accordance with SSI methodologies, that do not exceed twice the relevant maximum amount established, for SSI eligibility, for an individual or for an individual and his or her spouse; and (4) Is not otherwise eligible for Medicaid. Qualified Medicare Beneficiary (QMB) Qualifying Individual Quality improvement organization Regional Administrator Regional Office RHC RRB Secretary SNF Social security benefits Specified Low-Income Medicare Beneficiary (SLMB) SSA United States U.S.C. [48 FR 12534, Mar. 25, 1983] Editorial Note: For Federal Register www.govinfo.gov. § 400.202 Definitions specific to Medicare. As used in connection with the Medicare program, unless the context indicates otherwise— Carrier Critical access hospital (CAH) Departmental Appeals Board means: (2) For purposes of review of ALJ decisions under part 405, subparts G and H; part 417, subpart Q; part 422, subpart M; and part 478, subpart B of this chapter, the Medicare Appeals Council designated by the Board Chair. (3) For purposes of part 426 of this chapter, a Member of the Board and, at the discretion of the Board Chair, any other Board staff appointed by the Board Chair to perform a review under that part. Entitled Essential access community hospital (EACH) GME Hospital insurance benefits Intermediary Local coverage determination (LCD) Medicare integrity program contractor Medicare Part A Medicare Part B Medicare Part C Medicare Part D National coverage determination (NCD) Nonparticipating supplier Participating supplier Payment on an assignment-related basis (1) To a physician or other supplier that accepts assignment from the beneficiary, in accordance with § 424.55 or § 424.56 of this chapter; (2) To a physician or other supplier after the beneficiary's death, in accordance with § 424.64(c)(1) of this chapter; or (3) To an entity that pays the physician or other supplier under a health benefit plan, in accordance with § 424.66 of this chapter. Provider Railroad retirement benefits Services Supplementary medical insurance benefits Supplier [48 FR 12534, Mar. 25, 1983] Editorial Note: For Federal Register www.govinfo.gov. § 400.203 Definitions specific to Medicaid. As used in connection with the Medicaid program, unless the context indicates otherwise— Applicant Federal financial participation FMAP Intellectual disability Medicaid agency agency Nursing facility (NF), PCCM PCP Provider (1) For the fee-for-service program, any individual or entity furnishing Medicaid services under an agreement with the Medicaid agency. (2) For the managed care program, any individual or entity that is engaged in the delivery of health care services and is legally authorized to do so by the State in which it delivers the services. Services State State plan the plan [48 FR 12534, Mar. 25, 1983, as amended at 50 FR 33029, Aug. 16, 1985; 56 FR 8852, Mar. 1, 1991; 57 FR 29155, June 30, 1992; 67 FR 41094, June 14, 2002; 77 FR 29028, May 16, 2012] Subpart C [Reserved]