(State Gov't) External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364

2012 EXTERNAL QUALITY REVIEW (EQR) PROTOCOLS
APPENDIX IV: EQR ACRONYMS
ACA

Patient Protection and Affordable Care Act (Affordable Care Act)

AHRQ

Agency for Healthcare Research and Quality

AMA PCPI

American Medical Association Physician Consortium for Performance
Improvement

APCD

All-Payer Claims Database

ARRA

American Recovery and Reinvestment Act

BBA

Balanced Budget Act of 1997

CEO

Chief Executive Officer

CHIPRA

Children’s Health Insurance Program Reauthorization Act of 2009

CFO

Chief Financial Officer

CAHPS

Consumer Assessment of Healthcare Providers and Systems

CMS

Centers for Medicare & Medicaid Services

DHHS

Department of Health and Human Services

EQRO

External Quality Review Organization

HCFA

Health Care Financing Administration
®

HEDIS

Healthcare Effectiveness Data and Information Set

HITECH

Health Information Technology for Economic and Clinical Health Act

IPRO

Internal Peer Review Organization

ISCA

Information Systems Capability Assessment

JCAHO

The Joint Commission

MCO

Managed Care Organization

MRR

Medical Record Review

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 0938-0786. The time required
to complete this information collection is estimated to average 1,591 hours per response for all activities, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you
have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500
Security Boulevard, Attn: PRA Reports Clearance Officer, Baltimore, Maryland 21244-1850

EQR Protocol Appendix IV
EQR Acronyms – September 2012

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APPENDIX IV: EQR ACRONYMS – continued

NCQA

National Committee for Quality Assurance

PIHP

Prepaid Inpatient Health Plans

PIP

Performance Improvement Project

PRO

Peer Review Organization

QAPI

Quality Assessment and Performance Improvement

QI

Quality Improvement

QISMC

Quality Improvement System for Managed Care

SOW

Scope of Work

EQR Protocol Appendix IV
EQR Acronyms – September 2012

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