Code of Federal Regulations: Containing a Codification of Documents of General Applicability and Future Effect as of December 31, 1948, with Ancillaries and IndexDivision of the Federal Register, the National Archives, 1977 Special edition of the Federal Register, containing a codification of documents of general applicability and future effect ... with ancillaries. |
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Page 75
... organization to whom such assignment has been made : ( i ) Agrees to accept the individual's assignment of the right to receive pay- ment for such services ; ( ii ) Agrees that the reasonable charge for such services shall be the full ...
... organization to whom such assignment has been made : ( i ) Agrees to accept the individual's assignment of the right to receive pay- ment for such services ; ( ii ) Agrees that the reasonable charge for such services shall be the full ...
Page 118
... organizations relat- ed to the provider by common owner- ship or control are includable in the allowable cost of the provider at the cost to the related organization . How- ever , such cost must not exceed the price of comparable ...
... organizations relat- ed to the provider by common owner- ship or control are includable in the allowable cost of the provider at the cost to the related organization . How- ever , such cost must not exceed the price of comparable ...
Page 119
... organization is a bona fide separate or- ganization ; that a substantial part of its business activity of the type carried on with the provider is transacted with others than the provider and or- ganizations related to the supplier by ...
... organization is a bona fide separate or- ganization ; that a substantial part of its business activity of the type carried on with the provider is transacted with others than the provider and or- ganizations related to the supplier by ...
Page 125
... organization furnishing the services under arrangements requires the ser- vices of a therapist or therapists on an average of less than 15 hours per week . This determination shall be made by dividing the total hours of service ...
... organization furnishing the services under arrangements requires the ser- vices of a therapist or therapists on an average of less than 15 hours per week . This determination shall be made by dividing the total hours of service ...
Page 139
... organization other than the intermediary is paying the provider for services on a cost or cost- related basis , the intermediary may obtain from that organization or from the provider itself the rate of payment being used and other cost ...
... organization other than the intermediary is paying the provider for services on a cost or cost- related basis , the intermediary may obtain from that organization or from the provider itself the rate of payment being used and other cost ...
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Common terms and phrases
Administrative Law Judge agreement amount Appeals Council applicable appropriate approved basis carrier certification cian clinical coinsurance Condition of participation cost reporting coverage December 31 decision deductible diagnostic dialysis disease treatment facility end-stage renal disease enrollee enrollment entitled ESRD explaining the standard filed Health Care Financing health insurance program hearing HMO's home health agency hospital insurance individual inpatient hospital services insurance benefits intermediary items and services items or services laboratory medical record medical staff Medicare meets ment month notice outpatient paragraph party patient payment person personnel physi physical therapy physician pital portable X-ray premiums prior procedures provider of services pursuant qualified reasonable charges recertification Redesignated at 42 reim reimbursement renal dialysis renal disease treatment request Secretary Sept services furnished services rendered skilled nursing facility Social Security Act Social Security Administration speech pathology Subpart supervision supplementary medical insurance termination therapist tient tion utilization review vices
Popular passages
Page 325 - Prescribed drugs, dentures, and prosthetic devices; and eyeglasses prescribed by a physician skilled in diseases of the eye. or by an optometrist, whichever the individual may select.
Page 325 - hospital' also includes a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts, but only with respect to items and services ordinarily furnished by such...
Page 310 - Secretary) a full-time student or part-time student who is not a full-time employee attending a school, college, or university, or a course of vocational or technical training designed to fit him for gainful employment...
Page 283 - Security for the purpose of reviewing the status of the Federal OldAge and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, the Federal Hospital Insurance Trust Fund...
Page 35 - Routine and ancillary services, defined. For purposes of this section the term "routine services" means the regular room, dietary and nursing services, minor medical and surgical supplies, and the use of equipment and facilities for which a separate charge is not customarily made. Charges for two to four bed accommodations or the accommodations occupied, whichever is less, will be the basis for the routine charges allowed. The term "ancillary services" means those covered special services for which...
Page 16 - States or (B) an alien lawfully admitted for permanent residence who has resided in the United States (as...
Page 74 - No certifying or disbursing officer shall be held liable for any amount certified or paid by him to any person where the adjustment or recovery of such amount is waived under subsection (b), or where adjustment under subsection (a) is not completed prior to the death of all persons against whose benefits deductions are authorized.
Page 30 - ... (3) any item or service if it would not be included under subsection (b) if furnished to an inpatient of a hospital ; and "(4) any services furnished under such arrangements unless furnished in the hospital or in other facilities operated by or under the supervision of the hospital or its organized medical staff. "Physicians' Services "(q) The term 'physicians
Page 33 - Secretary determines is providing services to the public generally as a community institution or agency; and no such payment may be made to any provider of services for any item or service which such provider is obligated by a law of, or a contract with, the United States to render at public expense.
Page 325 - ... by a physician or other licensed practitioner of the healing arts within the scope of his professional practice as defined and limited by Federal and State law. With respect to "prescribed drugs...