State Agencies
CDHS or DHS
What is the Colorado Department of Human Services or Department of Human Services?
* Oversight over Colorado's mental, child & family services and disability programs.
DEA
What is the Drug Enforcement Agency?
* Each hospital pharmacy and provider writing prescriptions is required to have a DEA number. Also, DEA can inspect our pharmacies.
TJC
What is The Joint Commission?
* Accrediting healthcare agency that validates on behalf the CMS that safe, quality, and consistent patient care is being provided.
CoP
What is Conditions of Participation?
* Qualifications developed by CMS that healthcare organizations must meet in order to begin and continue participating in federally funded healthcare programs (Medicare, Medicaid, CHP+, etc.)
TRICARE
What is TRICARE?
* The uniformed services health care program for active duty service members (ADSMs), active duty family members (ADFMs), and retirees.
CDPHE
What is the Colorado Department of Public Health & Environment?
* Licenses, surveys/inspections, construction reviews
FDA
What is the Food & Drug Agency?
* All drugs and medical devices are approved by the FDA. FDA inspects our pharmacy and blood bank locations.
CLIA
What is the Clinical Laboratory Improvement Amendments?
* Regulates labs testing human specimens and ensures they provide accurate, reliable, and timely patient test results no matter where the test is done.
HIPAA
What is the Health Insurance Portability and Accountability Act?
* A federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge, includes both security and privacy rules.
MCR or MMCR
What is Medicare or Managed Medicare?
* Country's health insurance program for people age 65 or older and younger people receiving Social Security disability benefits and permanent kidney failure.
CDPS
What is the Colorado Department of Public Safety?
* Performs life safety & fire prevention inspections which is required for licensure upon opening & every 5 years
CMS
What is the Center for Medicare & Medicaid?
* Oversees programs including Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the state and federal health insurance marketplaces. Also, provides regulatory oversight through the conditions of participation.
ACS
What is the American College of Surgeons?
* Regulatory group that certifies the trauma and surgical services programs.
FMLA
What is the the Family Medical Leave Act?
* Entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons.
MCD or MMCD
What is Medicaid or Managed Medicaid?
* Medicaid covers eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements, and is funded jointly by states and the federal government.
DORA
What is the Department of Regulatory Agencies?
* State agency that manages licensure of all our professionals. Also, has oversight on professional disciplinary action.
OIG
What is the Office of the Inspector General?
* Charged with enforcing regulations about waste, fraud, and abuse.
ACR
What is the American College of Radiology?
* Accredits radiology programs to ensure safe and quality care is provided.
OSHA
What is the Occupational Safety and Health Act ?
* Ensures safe working conditions for workers by setting and enforcing standards and by providing training, outreach, education and assistance.
CHP+ or CHIP
What is Children's Health Plan+ or Children's Health Insurance Program?
* Public health insurance for children and pregnant women who earn too much to qualify for Health First Colorado (Colorado's Medicaid Program), but not enough to afford private health insurance.
HCPF
What is the the Health Care Policy & Financing department?
* Oversight of the Colorado Medicaid, Health First, and Child Health Plus Plan programs.
OCR
What is the Office for Civil Rights?
* Enforces federal civil rights laws, conscience and religious freedom laws, including HIPAA.
ACGME
What is the Accreditation Council for Graduate Medical Education?
* An organization that sets and monitors voluntary professional educational standards essential in preparing physicians to deliver safe, high-quality medical care.
EMTALA
What is the Emergency Medical Treatment and Labor Act?
* Requires hospitals with emergency departments to provide a medical screening examination to all individual. Prohibits hospitals to refuse care.
RAE
What is the Regional Accountable Entity's?
* Regional Accountable entities are managed care entities responsible for covering behavioral health benefits for nearly all Colorado Medicaid members.