...must be made to the beneficiary to whom the services were furnished. A refund is timely if— (1) A physician who does not request a review within 30...pay for the service; or (2) Before the service was provided(i) The physician informed the beneficiary, or someone acting on the beneficiary's behalf,...

...required to arrange for post-discharge care; and (2) It is determined, under § 405.332, that the SNF did not know, and could not reasonably have been expected to know that Medicare payment would not be made. [50 FR 33030, Aug. 16, 1985] § 405.167 Prohibition against payment for...

...the provider of the amount excluded and any cost share amount already paid) if: (i) The beneficiary did not know and could not reasonably have been expected to know that the services were excludable by reason of being not medically necessary; and (it) The provider knew...

...the provider of the amount excluded and any cost share amount already paid) if: (I) The beneficiary did not know and could not reasonably have been expected to know that the services were excludable by reason of being not medically necessary; and (II) The provider knew...

...character of a war crime, nor does it constitute a defense in the trial of an accused individual, unless he did not know and could not reasonably have been expected to know that the act ordered was unlawful. In all c,ases where the order is. held not to constitute a defense•...

...''(2) both such individual and such provider of services or such other person, as the case may be, did not know, and could not reasonably have been expected to know, that payment would not be made for such items or services under such part A or part B, 42 use 1395c, then...

...of a war crime, nor does it constitute a defense in the trial of the accused individual, unless he did not know and could not reasonably have been expected to know that the act ordered was unlawful. In all cases where the order is held not to constitute a defense to an...

...provision, a home health agency will be paid for noncovered services under either parts A and B if it did not know, and could not reasonably have been expected to know, that payment would not be made for such items or services. SSA officials advised us that interim instructions...

...limiting liability to individual beneficiaries what criteria will be used to determine when the individual "did not know and could not reasonably have been expected to know that payment would not be made . . .?" Insofar as the beneficiary is concerned, there will be a presumption...

...of a war crime, nor does it constitute a defense in the trial of the accused individual, unless he did not know and could not reasonably have been expected to know that the act ordered was unlawful. In all cases where the order is held not to constitute a defense to an...