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. |
From inside the book
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Page 6
... title XVIII incor- rect payments . 405.353 Certification of amount that will be adjusted against individual title II or railroad retirement benefits . 405.354 Procedures for adjustment or re- covery - title II beneficiary . 405.355 ...
... title XVIII incor- rect payments . 405.353 Certification of amount that will be adjusted against individual title II or railroad retirement benefits . 405.354 Procedures for adjustment or re- covery - title II beneficiary . 405.355 ...
Page 13
... TITLE XVIII 405.2040 Reimbursement HMO's - introduction . of cost - basis 405.2041 Cost reimbursement - general . 405.2042 Allowable costs . 405.2043 Cost apportionment . 405.2044 Adequate financial records , statis- tical data , and ...
... TITLE XVIII 405.2040 Reimbursement HMO's - introduction . of cost - basis 405.2041 Cost reimbursement - general . 405.2042 Allowable costs . 405.2043 Cost apportionment . 405.2044 Adequate financial records , statis- tical data , and ...
Page 17
... TITLE XVIII 405.2040 Reimbursement HMO's - introduction . of cost - basis 405.2041 Cost reimbursement - general . 405.2042 Allowable costs . 405.2043 Cost apportionment . 405.2044 Adequate financial records , statis- tical data , and ...
... TITLE XVIII 405.2040 Reimbursement HMO's - introduction . of cost - basis 405.2041 Cost reimbursement - general . 405.2042 Allowable costs . 405.2043 Cost apportionment . 405.2044 Adequate financial records , statis- tical data , and ...
Page 19
... title XVIII are available on a voluntary basis be- ginning July 1973 to eligible individ- uals age 65 or over who do not other- wise qualify for hospital insurance benefits and are willing to pay the full average cost of such insurance ...
... title XVIII are available on a voluntary basis be- ginning July 1973 to eligible individ- uals age 65 or over who do not other- wise qualify for hospital insurance benefits and are willing to pay the full average cost of such insurance ...
Page 52
... title XVIII of the Act ; and cases ( 4 ) On the basis of bills submitted by the skilled nursing facility , the HCFA finds that the facility effec- tively distinguishes between where the items or services furnished by the facility are ...
... title XVIII of the Act ; and cases ( 4 ) On the basis of bills submitted by the skilled nursing facility , the HCFA finds that the facility effec- tively distinguishes between where the items or services furnished by the facility are ...
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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...