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 8
... beneficiaries . 405.453 Adequate cost data and cost find- ing . 405.454 Payments to providers . cost 405.455 Amount of payments where cus- tomary charges for services furnished are less than reasonable cost . 405.460 Limitations on ...
... beneficiaries . 405.453 Adequate cost data and cost find- ing . 405.454 Payments to providers . cost 405.455 Amount of payments where cus- tomary charges for services furnished are less than reasonable cost . 405.460 Limitations on ...
Page 17
... beneficiary . For purposes of this Part 405 , the term " qualified railroad re- tirement beneficiary " means an indi- vidual whose name has been certified to the Social Security Administration by the Railroad Retirement Board under ...
... beneficiary . For purposes of this Part 405 , the term " qualified railroad re- tirement beneficiary " means an indi- vidual whose name has been certified to the Social Security Administration by the Railroad Retirement Board under ...
Page 29
... beneficiary ( or by someone acting on his behalf ( see paragraph ( e ) of this section ) ) at the time of admission to a hospital or at any time thereafter , subject to the limitations on retroac- tive elections described in paragraph ...
... beneficiary ( or by someone acting on his behalf ( see paragraph ( e ) of this section ) ) at the time of admission to a hospital or at any time thereafter , subject to the limitations on retroac- tive elections described in paragraph ...
Page 30
... beneficiary does not have private insurance and no other person agrees to pay the hospital for the services , then only the beneficiary's legal repre- sentative may file an election on the beneficiary's behalf . [ 35 FR 19992 , Dec. 31 ...
... beneficiary does not have private insurance and no other person agrees to pay the hospital for the services , then only the beneficiary's legal repre- sentative may file an election on the beneficiary's behalf . [ 35 FR 19992 , Dec. 31 ...
Page 81
... beneficiary's utilization record ( except where lifetime reserve days are involved ) . Example . A beneficiary received 45 days of inpatient hospital services for an injury that is compensable under workmen's com- pensation . This is ...
... beneficiary's utilization record ( except where lifetime reserve days are involved ) . Example . A beneficiary received 45 days of inpatient hospital services for an injury that is compensable under workmen's com- pensation . This is ...
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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.