EDITORIAL NOTE: Chapter IV is continued in the volume containing 42 CFR Part 430 to End. For the convenience of the user, the table of contents of chapter IV appearing in 42 CFR part 430 to end is set forth below. SUBCHAPTER C-MEDICAL ASSISTANCE PROGRAMS Part 430 431 432 433 434 435 436 440 441 442 447 455 456 462 466 473 476 482 483 484 485 488 489 491 Grants to states for Medical Assistance Programs State fiscal administration Contracts Eligibility in the states, the District of Columbia, Eligibility in Guam, Puerto Rico, and the Virgin Services: General provisions Services: Requirements and limits applicable to Standards for payment for skilled nursing and in- Payments for services Program integrity: Medicaid Utilization control SUBCHAPTER D-PEER REVIEW ORGANIZATIONS Peer review organizations Utilization and quality control review Reconsiderations and appeals Acquisition, protection, and disclosure of peer SUBCHAPTER E-STANDARDS AND CERTIFICATION Conditions of participation for hospitals Conditions of participation and requirements for Conditions of participation: Home health agen- Conditions of participation and conditions for Survey and certification procedures Provider agreements under Medicare Certification of certain health facilities 603 Conditions for Medicare payment.... EDITORIAL NOTE: Chapter IV is continued in the volume containing 42 CFR Part 430 to End. For the convenience of the user, the table of contents of chapter IV appearing in 42 Grants to states for Medical Assistance Programs State organization and general administration Eligibility in the states, the District of Columbia, the Northern Mariana Islands, and American Eligibility in Guam, Puerto Rico, and the Virgin Services: Requirements and limits applicable to SUBCHAPTER D-PEER REVIEW ORGANIZATIONS SUBCHAPTER E-STANDARDS AND CERTIFICATION Conditions of participation for hospitals Conditions of participation and requirements for Conditions of participation: Home health agen- Conditions of participation and conditions for coverage: Specialized providers Survey and certification procedures Part 493 498 Laboratory requirements Appeals procedures for determinations that affect participation in the Medicare program Sec. SUBCHAPTER A-GENERAL PROVISIONS PART 400-INTRODUCTION; DEFINITIONS Subpart A-[Reserved] Subpart B-Definitions In this chapter, unless the context indicates otherwise Act means the Social Security Act, and titles referred to are titles of that Act. Administrator means the Administrator, Health Care Financing Administration. Area means the geographical area within the boundaries of a State, or a State or other jurisdiction, designated as constituting an area with respect to which a Professional Standards Review Organization or a Utilization and Quality Control Peer Review Organization has been or may be designated. CFR stands for Code of Federal Regulations. Department means the Department of Health and Human Services (HHS), formerly the Department of Health, Education, and Welfare. ESRD stands for end-stage renal dis ease. FDA stands for the Food and Drug Administration. FR stands for Federal Register. HCFA stands for Health Care Financing Administration. HHS stands for the Department of Health and Human Services. HHA stands for home health agency. HMO stands for health maintenance organization. ICF stands for intermediate care facility. Medicaid means medical assistance provided under a State plan approved under title XIX of the Act. Medicare means the health insurance program for the aged and disabled under title XVIII of the Act. OASDI stands for the Old Age, Survivors, and Disability Insurance program under title II of the Act. PRO stands for Utilization and Quality Control Peer Review Organization. Regional Administrator means a Regional Administrator of HCFA. Regional Office means one of the regional offices of HCFA. RHC stands for rural health clinic. Secretary means the Secretary of Health and Human Services. ty. SNF stands for skilled nursing facili Social security benefits means monthly cash benefits payable under section 202 or 223 of the Act. SSA stands for Social Security Administration. United States means the fifty States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. U.S.C. stands for United States Code. Utilization and Quality Control Peer Review Organization (PRO) means an organization that has a contract with HCFA to review, under Part B of title XI of the Act, the health care services or items furnished or proposed to be furnished to Medicare beneficiaries. [48 FR 12534, Mar. 25, 1983, as amended at 49 FR 7206, Feb. 27, 1984; 50 FR 15326 and 15358, Apr. 17, 1985; 50 FR 41886, Oct. 16, 1985; 51 FR 43197, Dec. 1, 1986; 52 FR 27764, July 23, 1987] § 400.202 Definitions specific to Medicare. As used in connection with the Medicare program, unless the context indicates otherwise |