{"data":{"id":"us/42-cfr-400.200","jurisdiction":"us","citation":"42 CFR 400.200","heading":"General definitions.","body":"In this chapter, unless the context indicates otherwise—\nAct means the Social Security Act, and titles referred to are titles of that Act.\nAdministrator means the Administrator, Centers for Medicare \u0026 Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA).\nALJ stands for administrative law judge.\nArea means the geographical area within the boundaries of a State, or a State or other jurisdiction, designated as constituting an area with respect to which a Professional Standards Review Organization or a Utilization and Quality Control Peer Review Organization has been or may be designated.\nBeneficiary means a person who is entitled to Medicare benefits and/or has been determined to be eligible for Medicaid.\nCMP stands for competitive medical plan.\nConditions of participation includes requirements for participation as the latter term is used in part 483 of this chapter.\nCondition level deficiencies includes deficiencies with respect to “level A requirements” as the latter term is used in parts 442 and 483 of this chapter.\nCORF stands for comprehensive outpatient rehabilitation facility.\nCFR stands for Code of Federal Regulations.\nCMS stands for Centers for Medicare \u0026 Medicaid Services, formerly the Health Care Financing Administration (HCFA).\nCY stands for calendar year.\nDAB stands for Departmental Appeals Board.\nDepartment means the Department of Health and Human Services (HHS), formerly the Department of Health, Education, and Welfare.\nESRD stands for end-stage renal disease.\nFDA stands for the Food and Drug Administration.\nFQHC means Federally qualified health center.\nFR stands for Federal Register.\nFY stands for fiscal year.\nHCPP stands for health care prepayment plan.\nHHS stands for the Department of Health and Human Services.\nHHA stands for home health agency.\nHMO stands for health maintenance organization.\nICF stands for intermediate care facility.\nICF/IID stands for intermediate care facility for individuals with intellectual disabilities.\nMedicaid means medical assistance provided under a State plan approved under title XIX of the Act.\nMedicare means the health insurance program for the aged and disabled under title XVIII of the Act.\nMedicare Savings Programs (MSPs) has the same meaning described in § 435.4 of this chapter.\nNCD stands for national coverage determination.\nOASDI stands for the Old Age, Survivors, and Disability Insurance program under title II of the Act.\nOIG stands for the Department's Office of the Inspector General.\nPublic Health Emergency (PHE) means the Public Health Emergency determined to exist nationwide as of January 27, 2020, by the Secretary pursuant to section 319 of the Public Health Service Act on January 31, 2020, as a result of confirmed cases of COVID-19, including any subsequent renewals.\nQDWI stands for Qualified Disabled and Working Individual.\nQIO stands for quality improvement organization.\nQMB stands for Qualified Medicare Beneficiary.\nQualified Disabled and Working Individual means an individual who—\n(1) Is eligible to enroll for Medicare Part A under section 1818A of the Act.\n(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;\n(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\n(4) Is not otherwise eligible for Medicaid.\nQualified Medicare Beneficiary (QMB) means an individual described in § 435.123 of this chapter.\nQualifying Individual (QI) means an individual described in § 435.125 of this chapter.\nQuality improvement organization means an organization that has a contract with CMS, under part B of title XI of the Act, to perform utilization and quality control review of the health care furnished, or to be furnished, to Medicare beneficiaries.\nRegional Administrator means a Regional Administrator of CMS.\nRegional Office means one of the regional offices of CMS.\nRHC stands for rural health clinic.\nRRB stands for Railroad Retirement Board.\nSecretary means the Secretary of Health and Human Services.\nSNF stands for skilled nursing facility.\nSocial security benefits means monthly cash benefits payable under section 202 or 223 of the Act.\nSpecified Low-Income Medicare Beneficiary (SLMB) means an individual described in § 435.124 of this chapter.\nSSA stands for Social Security Administration.\nUnited States means the fifty States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.\nU.S.C. stands for United States Code.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER A—GENERAL PROVISIONS","PART 400—INTRODUCTION; DEFINITIONS","Subpart B—Definitions"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"f4695148e2fe8a7b49060d12fd7e3a38974ccd64ca34798721b0877765de72d7","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-137.450","next":"us/42-cfr-400.202"},"notice":"GroundRules: Original legal text. Not legal advice."}