The Code of Federal Regulations of the United States of AmericaU.S. Government Printing Office, 1979 The Code of Federal Regulations is the codification of the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government. |
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Page 13
... basis of a paid bill ; individual dies before receiving direct payment . 405.1684 Payment on the basis of an unpaid bill ; individual dies before receiv- ing direct payment or assigning pay- ment . 405.1685 Payment to organizations that ...
... basis of a paid bill ; individual dies before receiving direct payment . 405.1684 Payment on the basis of an unpaid bill ; individual dies before receiv- ing direct payment or assigning pay- ment . 405.1685 Payment to organizations that ...
Page 15
... BASIS HMO'S UNDER TITLE XVIII 405.2049 Reimbursement HMO's - Introduction . of risk - basis 405.2050 Determining adjusted incurred cost . 405.2051 Determining adjusted average per capita cost . 4G5.2052 Computation of the amount due to ...
... BASIS HMO'S UNDER TITLE XVIII 405.2049 Reimbursement HMO's - Introduction . of risk - basis 405.2050 Determining adjusted incurred cost . 405.2051 Determining adjusted average per capita cost . 4G5.2052 Computation of the amount due to ...
Page 34
... basis ; and ( 3 ) As a practical matter , the service can only be provided in a skilled nurs- ing facility ( or only in such a facility or a hospital ) on an inpatient basis . [ 40 FR 43896 , Sept. 24 , 1975. Redesignated at 42 FR 52826 ...
... basis ; and ( 3 ) As a practical matter , the service can only be provided in a skilled nurs- ing facility ( or only in such a facility or a hospital ) on an inpatient basis . [ 40 FR 43896 , Sept. 24 , 1975. Redesignated at 42 FR 52826 ...
Page 37
... basis . " Skilled nursing services or skilled re- habilitation services must be required and provided on a " daily basis " -i.e . , on essentially a 7 - day - a - week basis . However , if skilled rehabilitation serv- ices are not ...
... basis . " Skilled nursing services or skilled re- habilitation services must be required and provided on a " daily basis " -i.e . , on essentially a 7 - day - a - week basis . However , if skilled rehabilitation serv- ices are not ...
Page 38
... basis in the place of residence used as the individual's home , except that services may be fur- nished on an outpatient basis at a hos- pital , a skilled nursing facility , or cer- tain rehabilitation centers when it is necessary to ...
... basis in the place of residence used as the individual's home , except that services may be fur- nished on an outpatient basis at a hos- pital , a skilled nursing facility , or cer- tain rehabilitation centers when it is necessary to ...
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Common terms and phrases
Administration Administrative Law Judge AFDC agreement allowable cost amended amount applicable appropriate approved assets basis carrier certification charges clinic coinsurance contract cost reporting coverage deductible dialysis eligibility end-stage renal disease enrollees enrollment entitled ESRD Federal filed HCFA Health Care Financing health insurance program health services hearing HMO's ices ICF/MR income individual inpatient hospital services institution intermediary items and services items or services laboratory licensed medicaid agency medically needy Medicare meet ment month notice organization paragraph participation party patient payment person personnel physi physical therapy physician premiums procedures provider of services provider's qualified quirements recipients Redesignated at 42 reimbursement renal renal dialysis request requirements resident Secretary Sept serv services furnished skilled nursing facility Social Security Act Social Security Administration specified speech pathology staff Standard Subpart supervision supplementary medical insurance termination tient tion treatment utilization review vidual
Popular passages
Page 283 - ... except that such term shall not include a private organization which is not a nonprofit organization exempt from Federal income taxation under section 501 of the Internal Revenue Code of 1954 (or a subdivision of such organization) unless it is licensed pursuant to State law and it meets such...
Page 79 - XVIII of the Act with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made, under a workmen's compensation law or plan of the United States or a State.
Page 307 - In determining if a single capital expenditure exceeds $100.000, the cost of studies, surveys, designs, plans, working drawings, specifications, and other activities essential to the acquisition, improvement, modernization, expansion, or replacement of land, plant, building, and equipment are included.
Page 38 - ... (C) in the case of post-hospital extended care services, such services are or were required to be given because the individual needs or needed on a daily basis skilled nursing care (provided directly by or requiring the supervision of skilled nursing personnel) or other skilled rehabilitation services, which as a practical matter can only be provided in a skilled nursing facility on an inpatient basis...
Page 491 - ... provide safeguards which restrict the use or disclosure of information concerning applicants and recipients to purposes directly connected with the administration of aid to dependent children...
Page 164 - Secretary, would cover 75 percent of the customary charges made for similar services in the same locality during the last preceding calendar year elapsing...
Page 355 - ... (4) in the case of an agency or organization in any State in which State or applicable local law provides for the licensing of...
Page 481 - ... are found by the Secretary to be necessary for the proper and efficient operation of the plan...
Page 128 - ... the costs with respect to individuals covered by the in-surance programs established by this title will not be borne by individuals not so covered, and the costs with respect to individuals not so covered will not be borne by such insurance programs...
Page 376 - No person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subject to discrimination under any program or activity receiving Federal financial assistance.