HCCA Compliance Vocab with All
Answers and Illustrations Given
2 Midnight Rule - ✔✔Regulation included in the 2014 Medicare inpatient
prospective payment rule. Established that inpatient admissions spanning at
least two midnights qualify for Medicare Part A payments. Inpatient stays
lasting fewer than two midnights must be treated and billed as outpatient
services.
340B Pricing Program - ✔✔A federal program requiring drug manufacturers to
provide outpatient drugs to eligible health care organizations/covered entities
at significantly reduced prices.
Academic Research Organization (ARO) - ✔✔An academic institution that
performs or manages clinical research services usually by partnering with a
research sponsor.
Adjusted Average per Capita Cost (AAPCC) - ✔✔CMS/HCFA's best estimate for
the amount of money it costs to care for Medicare recipients under fee-for-
services Medicare in a given area. The AAPCC is made up of 142 different rate
cells; 140 of them are factored for age, sex, Medicaid eligibility, Institutional
1|Page
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,status, working ages, and whether a person has both Part A and Part B of
Medicare. The 2 remaining cells are for individuals with end stage renal disease.
Adjusted Community Rate (ACR) - ✔✔Under the ACA, insurers can't raise
premiums based on health status, medical claims, gender, or most of the other
factors that they had previously used to determine rates prior to ACA
implementation.
Advance Beneficiary Notice (ABN) - ✔✔A waiver signed by a patient confirming
the patient's understanding that certain provided services may not be
reimbursable under Medicare and therefore are the patient's responsibility.
Advanced Medical Technology Association (Advamed) - ✔✔Medical device
trade association.
Adverse Drug Experience (ADE) - ✔✔Any adverse event associated with the use
of a drug in humans, whether or not considered drug-related, including the
following: An adverse event occurring in the course of the use of a drug product
in professional practice; an adverse event occurring from drug overdose
whether accidental or intentional; an adverse event occurring from drug abuse;
an adverse event occurring from drug withdrawal; and any failure of expected
pharmacological action.
Adverse Drug Reaction (ADR) - ✔✔Injury caused by taking a medication.
2|Page
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,Adverse Event (Research) (AE) - ✔✔Used broadly to mean any untoward or
unfavorable medical occurrence in a human subject, including any abnormal
sign, symptom, or disease, temporally associated with the subject's
participation in research, whether or not considered related to the subject's
participation in the research. Adverse events encompass both physical and
psychological harms.
Affiliated Covered Entity (ACE) - ✔✔Under HIPAA, legally separate covered
entities under common ownership or control have an option to be treated as a
single legal entity by choosing to designate as ACE. This enables the entities to
share information in a way that would otherwise be impermissible (use vs.
disclosure).
Agency for Healthcare Research and Quality (AHRQ) - ✔✔Agency within the
Department of Health and Human Services, whose mission is to produce
evidence to make health care safer, higher quality, more accessible, equitable,
and affordable, and to work within HHS and other partners to make sure that
the evidence is understood and used.
Ambulatory Care Center (ACC) - ✔✔Medical provide with services aimed at one-
day surgical patients and non-surgical outpatients. Patients treated in ACCs
include pediatric, adolescent, adult and geriatric.
3|Page
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
, Ambulatory Patient Class (APC) - ✔✔Method used to pay hospitals and surgery
centers for outpatient services using a Prospective Payment System (PPS). Each
service is assigned to various APC categories.
Ambulatory Patient Groups (APG) - ✔✔A Medicare patient classification system
designed to explain the amount and types of resources consumed in an
ambulatory visit. There are 290 APGs in the current version (Version 2.0) and
they encompass the full range of services delivered in the ambulatory setting,
including same day surgery units, hospital emergency rooms and outpatient
clinics.
Ambulatory Surgery Center (ASC) - ✔✔Medical facility providing same-day
surgical care.
American College of Healthcare Executives (ACHE) - ✔✔Professional society of
healthcare executives who lead hospitals, health systems, and other healthcare
organizations.
American College of Professional Coders (AAPC) - ✔✔Professional association
that provides education and certification to medical coders.
4|Page
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
Answers and Illustrations Given
2 Midnight Rule - ✔✔Regulation included in the 2014 Medicare inpatient
prospective payment rule. Established that inpatient admissions spanning at
least two midnights qualify for Medicare Part A payments. Inpatient stays
lasting fewer than two midnights must be treated and billed as outpatient
services.
340B Pricing Program - ✔✔A federal program requiring drug manufacturers to
provide outpatient drugs to eligible health care organizations/covered entities
at significantly reduced prices.
Academic Research Organization (ARO) - ✔✔An academic institution that
performs or manages clinical research services usually by partnering with a
research sponsor.
Adjusted Average per Capita Cost (AAPCC) - ✔✔CMS/HCFA's best estimate for
the amount of money it costs to care for Medicare recipients under fee-for-
services Medicare in a given area. The AAPCC is made up of 142 different rate
cells; 140 of them are factored for age, sex, Medicaid eligibility, Institutional
1|Page
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,status, working ages, and whether a person has both Part A and Part B of
Medicare. The 2 remaining cells are for individuals with end stage renal disease.
Adjusted Community Rate (ACR) - ✔✔Under the ACA, insurers can't raise
premiums based on health status, medical claims, gender, or most of the other
factors that they had previously used to determine rates prior to ACA
implementation.
Advance Beneficiary Notice (ABN) - ✔✔A waiver signed by a patient confirming
the patient's understanding that certain provided services may not be
reimbursable under Medicare and therefore are the patient's responsibility.
Advanced Medical Technology Association (Advamed) - ✔✔Medical device
trade association.
Adverse Drug Experience (ADE) - ✔✔Any adverse event associated with the use
of a drug in humans, whether or not considered drug-related, including the
following: An adverse event occurring in the course of the use of a drug product
in professional practice; an adverse event occurring from drug overdose
whether accidental or intentional; an adverse event occurring from drug abuse;
an adverse event occurring from drug withdrawal; and any failure of expected
pharmacological action.
Adverse Drug Reaction (ADR) - ✔✔Injury caused by taking a medication.
2|Page
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,Adverse Event (Research) (AE) - ✔✔Used broadly to mean any untoward or
unfavorable medical occurrence in a human subject, including any abnormal
sign, symptom, or disease, temporally associated with the subject's
participation in research, whether or not considered related to the subject's
participation in the research. Adverse events encompass both physical and
psychological harms.
Affiliated Covered Entity (ACE) - ✔✔Under HIPAA, legally separate covered
entities under common ownership or control have an option to be treated as a
single legal entity by choosing to designate as ACE. This enables the entities to
share information in a way that would otherwise be impermissible (use vs.
disclosure).
Agency for Healthcare Research and Quality (AHRQ) - ✔✔Agency within the
Department of Health and Human Services, whose mission is to produce
evidence to make health care safer, higher quality, more accessible, equitable,
and affordable, and to work within HHS and other partners to make sure that
the evidence is understood and used.
Ambulatory Care Center (ACC) - ✔✔Medical provide with services aimed at one-
day surgical patients and non-surgical outpatients. Patients treated in ACCs
include pediatric, adolescent, adult and geriatric.
3|Page
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
, Ambulatory Patient Class (APC) - ✔✔Method used to pay hospitals and surgery
centers for outpatient services using a Prospective Payment System (PPS). Each
service is assigned to various APC categories.
Ambulatory Patient Groups (APG) - ✔✔A Medicare patient classification system
designed to explain the amount and types of resources consumed in an
ambulatory visit. There are 290 APGs in the current version (Version 2.0) and
they encompass the full range of services delivered in the ambulatory setting,
including same day surgery units, hospital emergency rooms and outpatient
clinics.
Ambulatory Surgery Center (ASC) - ✔✔Medical facility providing same-day
surgical care.
American College of Healthcare Executives (ACHE) - ✔✔Professional society of
healthcare executives who lead hospitals, health systems, and other healthcare
organizations.
American College of Professional Coders (AAPC) - ✔✔Professional association
that provides education and certification to medical coders.
4|Page
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
