Advance beneficiary notice of noncoverage (ABN) - answerMedicare form used to inform a patient that a service to be provided is not likely to be reimbursed by the program. crossover claim - answerClaim for services to a Medicare/Medicaid beneficiary; Medicare is the primary payer and automatically transmits claim information to Medicaid as the secondary payer. formulary - answerA list of a Health plan's selected drugs and their proper dosages; often a plan pays only for the drugs it lists. hospice - answerA public or private organization that provides services for terminally ill people and their families. limiting charge - answerIn Medicare, the highest fee (115 percent of the Medicare Fee Schedule) that nonparticipating physicians can charge for a particular service. local coverage determination (LCDs) - answerFormely called Local Medicare Review Policies (LMRPs), these are issued by Medicare to help clarify medical necessity issues. Medical Savings Account (MSA) - answerThe Medicare health savings account program. Medicare - answerThe federal health insurance progran for people 65 or older and some people with desabilities. Medicare administrative contractor (MAC) - answerNew entities assigned by CMS to replace the Part A fiscal intermediaries and the Part B carriers; also known as A/B MACs, they handle claims and related functions for both Parts A and B withing specific multistate jurisdictions. DME MACs handle claims for durable medical equipment, supplies, and drugs billed by physicians. Medicare Advantage - answerMedicare plans other than the Original Medicare Plan. Medicare beneficiary - answerA person covered by Medicare. Medicare Fee Schedule (MFS) - answerThe RBRVS-based allowed fees that are reimbursable to Medicare participating physicians. Medicare Modernization Act (MMA) - answerShort name for the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Medicare part A - answerThe part of the Medicare program that pays for hospitalization, care in a skilled nursing facility, home health care, and hospice care. Medicare Part B - answerThe part of the Medicare program that pays for physician services, outpatient hospital services, durable medical equipment, and other services and supplies.