Glossary


South Carolina Medicaid terminology: SC Web Tool, Screening Requirements, Credit Balance Reporting, Third-Party Liability, Adjustments



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T

Tax Equity and Fiscal Responsibility Act

(TEFRA) - The Tax Equity and Fiscal Responsibility Act Medicaid Eligibility Option, was developed to allow children with disabilities from near-poor and middle-income families to qualify for Medicaid.

Third Party Liability

Third Party Liability (TPL) refers to the legal obligation of third parties, i.e., certain individuals, entities, or programs, to pay all or part of the expenditures for medical assistance furnished under a state plan.  The Medicaid program by law is intended to be the payer of the last resort; that is, all other available third party resources must meet their legal obligation to pay claims before the Medicaid program pays for the care of an individual eligible for Medicaid.

Trading Partner Agreement

(TPA) - An established set of expectations between two entities exchanging HIPAA related electronic transactions.  A mechanism to communicate and document interim data guidelines and requirements.

TRICARE

TRICARE (formerly CHAMPUS) is the Health Services and Support program for DoD beneficiaries.