Medical & Legal Glossary

Emergency Medical Treatment and Labor Act - Federal law requiring hospitals to provide emergency screening and stabilizing treatment regardless of ability to pay or immigration status

Health Insurance Portability and Accountability Act - Federal law protecting the privacy and security of health information

Federal law enacted in 2010 to expand healthcare coverage and establish patient protections, also known as Obamacare

Civil rights provision of the ACA prohibiting discrimination in healthcare based on race, color, national origin, sex, age, or disability

Federal civil rights law prohibiting discrimination based on race, color, or national origin in federally funded programs

Federal law prohibiting discrimination against individuals with disabilities in all areas of public life

Federal law prohibiting discrimination based on disability in programs receiving federal funding

Federal law prohibiting employment discrimination based on race, color, religion, sex, or national origin

Federal health insurance program for people 65 or older and certain younger people with disabilities

Joint federal and state program providing health coverage to eligible low-income individuals

Consolidated Omnibus Budget Reconciliation Act - Allows workers to continue health insurance after job loss

Family and Medical Leave Act - Provides unpaid, job-protected leave for family and medical reasons

Federal law requiring hospitals that received construction funds to provide free or reduced-cost care

Federal law establishing patient rights and protections in healthcare

Federal law requiring equal coverage for mental health and physical health services

Limited Medicaid coverage for emergency medical conditions available to undocumented immigrants who meet income requirements

Optional provision under ACA allowing states to extend Medicaid to adults up to 138% of Federal Poverty Level

Children's Health Insurance Program - Federal program providing health coverage to eligible children in families with incomes too high for Medicaid

Insurance plan certified by Health Insurance Marketplace that meets ACA requirements for essential health benefits

Ten categories of services that health insurance plans must cover under the ACA, including emergency services and maternity care

Monthly payment for health insurance coverage

Amount you pay for healthcare services before your insurance begins to pay

Fixed amount you pay for a covered healthcare service

Percentage of costs you pay for covered healthcare services after meeting your deductible

Most you pay during a policy period before your insurance pays 100% of covered services

Facilities, providers, and suppliers your health insurer has contracted with to provide healthcare services

Approval from health plan required before receiving certain services or medications

Statement from insurance company explaining what was covered and what you owe

Health problem that existed before new health coverage starts

Period when you can enroll in health insurance or make changes to your plan

Time outside open enrollment when you can sign up for health insurance due to qualifying life event

Financial assistance to help pay for health insurance purchased through the Marketplace

Discount that lowers out-of-pocket costs for deductibles, copayments, and coinsurance

Health insurance plan with low premiums and very high deductibles for worst-case scenarios

List of prescription drugs covered by a health insurance plan

Initial evaluation required under EMTALA to determine if an emergency medical condition exists

Medical treatment necessary to ensure that an emergency medical condition will not deteriorate during transfer

Process of determining the priority of patients' treatments based on the severity of their condition

Process by which a patient learns about and understands the purpose, benefits, and risks of a medical procedure before agreeing to it

Process of developing a plan for a patient's care and support after leaving the hospital

Written order from primary care doctor for you to see a specialist or get certain medical services

Consultation with another healthcare provider to confirm diagnosis or treatment plan

Documentation of patient's medical history, diagnoses, treatments, and test results

Movement of patient from one healthcare facility to another for continued care

Formal acceptance of a patient into a hospital for treatment

Hospital stay where doctors monitor condition to decide if admission is needed

Medical care that does not require an overnight hospital stay

Medical care requiring admission and overnight stay in a hospital

Hospital department providing immediate treatment for urgent and life-threatening conditions

Walk-in clinic for non-life-threatening medical conditions requiring prompt attention

Immigration concept referring to someone likely to become dependent on government benefits

Immigration status that includes various categories of individuals authorized to be in the US, affecting healthcare eligibility

Deferred Action for Childhood Arrivals - Immigration policy allowing certain individuals brought to the US as children to receive renewable two-year periods of deferred action

Temporary Protected Status - Immigration status granted to eligible nationals of designated countries facing ongoing armed conflict or natural disasters

Nonimmigrant status for victims of certain crimes who have suffered mental or physical abuse and are helpful to law enforcement

Nonimmigrant status for victims of human trafficking

Protection granted to foreign nationals already in the US who meet the definition of refugee

Legal status for individuals fleeing persecution who are resettled in the US

Individual authorized to live and work permanently in the US, also known as green card holder

Foreign-born individual who has become a US citizen through the naturalization process

Income measure used to determine eligibility for federal programs, updated annually

Payment system that adjusts healthcare costs based on a patient's ability to pay, typically based on income and family size

Free or discounted healthcare services provided by hospitals to patients who cannot afford to pay

Economic difficulty that may qualify a patient for reduced-cost or free healthcare services

Money owed for healthcare services, which has special protections under federal and state laws

Statement of charges for healthcare services provided

Agreement to pay medical bills over time in installments

Hospital program offering free or reduced-cost care to eligible patients

Bankruptcy filed primarily due to inability to pay medical bills

Process of attempting to recover unpaid medical debt

Detailed breakdown of all charges for medical services

Standardized code used to describe medical services for billing and insurance purposes

Practice of billing patient for difference between provider's charge and insurance payment

Federal law protecting patients from unexpected medical bills for emergency and certain non-emergency services

Healthcare services or supplies needed to diagnose or treat an illness or medical condition

Federally Qualified Health Center - Community-based healthcare provider receiving federal funding to provide primary care services in underserved areas

Healthcare facility providing comprehensive primary care services to medically underserved populations

Hospital that provides care to patients regardless of their ability to pay or insurance status

Hospital affiliated with medical school where doctors receive training

Healthcare facility providing medical services at no cost to uninsured or underinsured patients

Healthcare professional who serves as first point of contact for medical care

Healthcare provider with advanced training in specific area of medicine

Advanced practice registered nurse who can diagnose and treat medical conditions

Healthcare professional licensed to practice medicine under supervision of physician

Healthcare professional who coordinates patient care and connects patients with resources

Medical condition with acute symptoms severe enough that absence of immediate medical attention could reasonably result in serious jeopardy to health

Short-term treatment for severe injury, illness, urgent medical condition, or during recovery from surgery

Long-lasting health condition that requires ongoing medical attention and may limit daily activities

Healthcare services designed to prevent illness or detect health problems early when treatment is most effective

Basic healthcare services including routine checkups, health screenings, and treatment of common illnesses

Medical care provided by healthcare professionals with advanced training in specific medical fields

Specialized medical care focused on providing relief from symptoms and stress of serious illness

End-of-life care focused on comfort and quality of life rather than cure

Treatment to restore function and quality of life after illness or injury

Medical care provided in patient's home by healthcare professionals

Document outlining the rights and responsibilities of patients receiving medical care

Person who helps patients navigate the healthcare system and ensures their rights are protected

Professional who provides language interpretation services during medical encounters

Services ensuring that individuals with limited English proficiency can access healthcare services

Term describing individuals who do not speak English as their primary language and have limited ability to read, write, speak, or understand English

Patient's legal right to decline medical treatment

Legal protections for patient health information under HIPAA

Any health information that can be linked to a specific individual

Document explaining how healthcare provider may use and share patient information

Legal document specifying medical treatment preferences if unable to communicate decisions

Legal document appointing someone to make medical decisions on your behalf if you cannot

Legal document stating preferences for end-of-life medical treatment

Medical order indicating that CPR should not be performed if heart or breathing stops

Official who investigates complaints and mediates disputes between patients and healthcare facilities

Formal complaint about healthcare services or treatment

Formal allegation filed with government agencies regarding discrimination in healthcare based on protected characteristics

Unauthorized use or disclosure of protected health information that violates federal privacy laws

Federal agency within HHS that enforces civil rights laws in healthcare

Federal agency that administers Medicare, Medicaid, and CHIP programs

Formal request to review a decision about healthcare coverage or treatment

Independent review of insurance company's decision to deny coverage or payment

Formal process to appeal denial of Medicaid benefits

Official who presides over appeals of government benefit decisions

Time limit for filing legal complaints or lawsuits

Adverse action taken against someone for exercising their legal rights

Legal requirement that mental health and substance abuse benefits be equal to medical and surgical benefits

Umbrella term for mental health and substance abuse services and treatment

Immediate, short-term help for individuals experiencing mental health emergencies

National hotline providing free, confidential support for people in mental health crisis

Medical and therapeutic services for individuals with alcohol or drug addiction

Remote delivery of healthcare services using telecommunications technology

Digital version of a patient's paper chart containing medical history, diagnoses, medications, and treatment plans

Secure online website giving patients access to their health information

Broader term for remote healthcare services including education and administrative functions

Electronic sharing of health information across different healthcare organizations