Sec. 405.520 Reimbursement for services of interns, residents and supervising physicians; general. 405.521 Services of attending physicians supervising interns and residents. 405.522 Interns' and residents' services in approved teaching programs. 405.523 Interns' and residents' services not in approved teaching programs. 405.524 Interns' and residents' services outside the hospital. 405.525 Basis of reimbursement to providers under the health insurance program for services of interns and residents. 405.541 Criteria for determination of reasonable charges for nonprovider renal dialysis facility services. 405.542 Criteria for determination of reasonable charges for physicians' services rendered to renal dialysis patients. 405.543 Criteria for determination of reasonable charges for physicians renal transplantation services. 405.544 Payment for durable medical equipment and supplies for home dialysis. Sec. 405.621 Appropriate time limits within which provider action must be taken. 405.622 Incorrect collections; payment of offset amounts to beneficiary or other person. 405.625 Transfer of provider ownership; general. 405.626 Change of ownership; participating in the health insurance program. 405.640 Notice of determination by the Secretary rescinding approval of coverage of services of independent laboratory or supplier of portable X-ray services. 405.651 Nomination of agency or organization as "intermediary"; contractual undertakings with intermediaries. 405.652 Nomination procedure. 435.653 Nomination by providers of services; nonmembers or nonconcurring members of a group or association. 405.654 Election to deal through a nomi nated agency or organization or to deal directly with the Secretary. 405.655 Notification of selection or nonselection of nominated agency or organization. 405.656 Withdrawal of nomination or election. 405.658 Emergency hospital services; hospital election to receive health insurance payments. 405.659 Reinstatement of emergency service hospital after notice of failure to continue to comply. 405.660 Criteria considered by Secretary in determining whether to enter into an agreement pursuant to section 1816 with a nominated agency or organization. 405.662 Termination by intermediary. 405.663 Termination by Secretary. 405.670 Contracts with carriers pursuant to section 1842; general. 405.671 Carrier: defined. 405.672 Competitive bidding for contract not required. 405.673 Carrier's ability to perform duties; financial responsibility; etc. 405.675 Termination of section 1842 contract by notice of nonrenewal. 405.676 Termination of section 1842 contract by Secretary for cause. 405.677 Functions which a carrier may perform under contract with the Secretary. 405.678 Duties to be performed by a carri er. 405.685 Agreenients with States pursuant to section 1864; general. 405.690 Agreements with ESRD facilities for reimbursement of home dialysis equipment without regard to deductibles and coinsurance. 405.715 Reconsidered determination. 405.716 Notice of reconsidered determination. 405.717 Effect of a reconsidered determination. 405.718 Expedited appeals process; conditions for use of such process. 405.718a Expedited appeals process; place and time of filing request. 405.718b Expedited appeals process; parties. 405.718c Expedited appeals process; agreement requirements. 405.718d Expedited appeals process; effect of agreement. 405.718e Effect of a request that does not result in agreement. 405.720 Hearing; right to hearing. 405.722 Time and place of filing request for a hearing. 405.724 Appeals Council review. Sec. 405.808 Parties to the review. 405.809 Opportunity to submit evidence. 405.820 Right to hearing. 405.821 Request for hearing. 405.822 Parties to a hearing. 405.823 Hearing officer. 405.824 Disqualification of hearing officer. 405.825 Location of hearing. 405.826 Notice of hearing. 405.830 Conduct of the hearing. 405.831 Waiver of right to appear and present evidence. 405.832 Dismissal of request for hearing. 405.833 Record of hearing. 405.834 Hearing officer's decision. 405.835 Effect of hearing officer's decision. 405.841 Reopening initial or review deter mination of the carrier, and decision of a hearing officer. 405.842 Notice of reopening and revision. 405.850 Change of ruling or legal precedent. 405.860 Authority of the hearing officer. 405.870 Appointment of representative. 405.871 Qualifications of representatives. 405.872 Authority of representatives. 405.913 Collection of overdue premiums for months in a closed taxable year. 405.914 Payment within the grace period. 405.915 Possible entitlement to social security or railroad retirement benefits. 405.916 Effect of entitlement to age-72 special payment. 405.920 Premium payment; individual not entitled to monthly benefits and not enrolled pursuant to Federal-State agreement. 405.921 Payment of premium on monthly or 3-month basis. 405.927 Due date and grace period. 405.928 Extension where last day of grace period is a nonworkday. 405.929 Extension of grace period for good cause. 405.1011 Hospitals Provision of emergency services by nonparticipating hospitals. 405.1020 Condition of participation-compliance with State and local laws. 405.1021 Condition of participation-Governing body. 405.1022 Condition of participation-Physical environment. 405.1023 Condition of participation-Medical staff. 405.1024 Condition of participation-Nursing department. 405.1025 Condition of participation-Dietary department. 405.1026 Condition of participation-Medi cal record department. 405.1027 Condition of participation-Pharmacy or drug room. 405.1028 Condition of participation-Laboratories. 405.1029 Condition of participation-Radiology department. 405.1030 Condition of participation-Medical library. 405.1031 Condition of participation-Complementary departments. 405.1032 Condition of participation-Outpatient department. 405.1033 Condition of participation-Emergency service or department. 405.1034 Condition of participation-Social work department. 405.1035 Condition of participation-Utilization review plan. Sec. 405.1221 Condition of participation: Organization, services, administration. 405.1222 Condition of participation: Group of professional personnel. 405.1223 Condition of participation: Acceptance of patients, plan of treatment, medical supervision. 405.1224 Condition of participation: Skilled nursing service. 405.1225 Condition of participation: Therapy services. 405.1226 Condition of participation: Medical social services. 405.1227 Condition of participation: Home health aide services. 405.1228 Condition of participation: Clinical records. 405.1229 Condition of participation: Evaluation. 405.1230 Condition of participation: Qualifying to provide outpatient physical therapy or speech pathology services. APPENDIX-Addenda for Several States Incorporating Conditions of Participation Higher Than Those Imposed by the Health Insurance for the Aged Program. 405.1554 Notice of dismissal and right to request review thereof. 405.1555 Effect of dismissal. 405.1556 Vacation of dismissal of request for hearing. 405.1557 Administrative Law Judge's decision. 405.1558 Effect of Administrative Law Judge's decision. 405.1559 Removal of hearing to the Appeals Council. 405.1560 Remand by the Administrative Law Judge. 405.1561 Right to request a review of Administrative Law Judge's decision or dismissal. 405.1562 Time and place of filing requests for review. 405.1563 Action by the Appeals Council on request for review. 405.1564 Procedures before the Appeals Council on review. 405.1565 Evidence admissible on review. 405.1566 Decision of the Appeals Council or remanding of case. 405.1567 Effect of the Appeals Council decision. 405.1568 Dismissal by Appeals Council. 405.1569 Extension of time to request a hearing or review or begin civil action. 405.1570 Reopening decisions of an Administrative Law Judge or the Appeals Council. 405.1571 Notice of revision. |