| United States. Supreme Court - 1984 - 1138 pages
...preceding year. See 42 CFR ยง 405.504(a)(2)(i) (1980) (denning "prevailing charge" as the fee that "would cover 75 percent of the customary charges made...is submitted or the request for payment is made") (emphasis added). Prudential defined respondent's own catalog price as the relevant "prevailing charge"... | |
| 1971 - 694 pages
...charge may be determined to be reasonable if it exceeds the higher of (1) the prevailing charge limit that, on the basis of statistical data and methodology...during the calendar year preceding the start of the fiscal year in which the determination is made, or (2) the prevailing charge limit in effect on December... | |
| 1977 - 1076 pages
...for similar services in the same locality during the calendar year preceding the start of the fiscal year in which the claim is submitted or the request...December 31, 1970, provided such prevailing charge limit had been found acceptable by the Secretary. (3) (i) In the case of physicians' services, each... | |
| 1978 - 1226 pages
...bills submitted or requests for payment made under this part if it exceeds the prevailing charge level that, on the basis of statistical data and methodology...for similar services in the same locality during the last preceding calendar year elapsing prior to the start of the fiscal year in which the bill is submitted... | |
| 1982 - 964 pages
...charge that, on the basis of statistical data and methodology acceptable to HCFA, would cover: (A) 75 percent of the customary charges made for similar...same locality during the calendar year preceding the fee screen year July 1 through June 30) in which the service was furnished; or (B) In the case of services... | |
| 1997 - 780 pages
...screen year (January 1 through December 31) in which the claim or request for payment is submitted, 75 percent of the customary charges made for similar services in the same locality during the 12 month period of July 1 through June 30 preceding the fee screen year that ends immediately preceding... | |
| 1987 - 776 pages
...screen year (January 1 through December 31) in which the claim or request for payment is submitted, 75 percent of the customary charges made for similar services in the same locality during the 12 month period of July 1 through June 30 preceding the fee screen year that ends immediately preceding... | |
| 1981 - 1372 pages
...methodology acceptable to the Director, OCHAMPUS (or a designee), does not exceed the 75th percentile of the customary charges made for similar services in the same locality during the last preceding calendar year elapsing prior to July 1 of the year in which the claim is received by... | |
| United States - 1972 - 276 pages
...same locality in administering this part on December 31, 1970, or (ii) the prevailing charge level that, on the basis of statistical data and methodology...for similar services in the same locality during the last preceding calendar year elapsing prior to the start of the fiscal year in which the bill is submitted... | |
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