The Code of Federal Regulations of the United States of AmericaThe 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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accordance adjusted Administration agency agreement allowable amended amount Appeals applicable appropriate approved authorized basis beginning beneficiary benefits Board carrier chapter charges claim clinic contract cost cost reporting coverage covered decision described determination dialysis direct effective enrollees enrollment entitled equipment ESRD established facility Federal filed HCFA hearing hospital ices individual initial inpatient intermediary laboratory least limited means Medicare meet ment method month necessary needs notice nursing officer operating organization paid paragraph participation party patient payment performed period person personnel physical physical therapy physician policies premiums procedures provider qualified reasonable receive records reimbursement request requirements respect responsible rules Secretary Sept serv services furnished Social Security specified staff Standard submitted Subpart supplier termination therapy tion title XVIII treatment United unless written
Popular passages
Page 71 - Notwithstanding any other provisions of this title, no payment may be made under part A or part B for any expenses incurred for items or services — (1) which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member...
Page 76 - Payment under this title may not be made with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made (as determined in accordance with regulations), with respect to such item or service, under a workmen's compensation law or plan of the United States or a State.
Page 203 - USE OF STATE AGENCIES TO DETERMINE COMPLIANCE BY PROVIDERS OF ' SERVICES WITH CONDITIONS OF PARTICIPATION "SEC. 1864. (a) The Secretary shall make an agreement with any State which is able and willing to do so under which the services of the State health agency or other appropriate State agency (or the appropriate local agencies) will be utilized by...
Page 236 - For purposes of clause (1) of the preceding sentence, the cost of the studies, surveys, designs, plans, working drawings, specifications, and other activities essential to the acquisition, improvement, expansion, or replacement of the plant and equipment with respect to which such expenditure is made shall be included in determining whether such expenditure exceeds $100,000.
Page 370 - ... (4) in the case of an agency or organization in any State in which State or applicable local law provides for the licensing of agencies or organizations of this nature, (A) is licensed pursuant to such law, or (B) is approved, by the agency of such State or locality responsible for licensing...
Page 231 - Being known to the plaintiff, it is to be presumed, in the absence of any evidence to the contrary, that the parties contracted in reference to it.
Page 211 - ... he may institute for the United States, or in the name of the United States, an action in a district court of the United States, in accordance with sections 1391 through 1393 of title 28, United States Code, for a restraining order, a preliminary or permanent injunction, or such other order as he deems appropriate.
Page 447 - States or (B) an alien lawfully admitted for permanent residence who has resided in the United States (as...
Page 143 - ... 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 190 - Paragraph (4) shall not apply to services provided in the hospital by an intern or a resident-in-training under a teaching program approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association...