Selected Issues in Medicare Program Policy: Hearing Before the Subcommittee on Health of the Committee on Ways and Means, House of Representatives, Ninety-fourth Congress, First Session ... June 12, 1975
U.S. Government Printing Office, 1975 - 500 pages
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action additional Administration admission aged allowed amendments American application appropriate areas Association average basis beds believe beneficiaries Chairman changes charges Chicago committee concern Congress consideration continue cost differential court decision Department determination developed differences economic Education effective elimination established facilities fact factors Federal further hearing Hospital Association hospitals Illinois implementation increase indicated individual inpatient institutions intent issues June limits Means Medicaid Medicare patients Medicare program Michigan necessary nursing salary Office operation payment percent period physicians practice present problems procedures proposed proposed regulations PSRO question reasonable receive reduce Register regulations reimbursement represent require responsibility result revised routine routine nursing rural Secretary Social Security Social Security Administration specific staff statement stay studies tion units utilization review Washington
Page 161 - legal interest" test goes to the merits. The question of standing is different. It concerns, apart from the "case" or "controversy" test, the question whether the interest sought to be protected by the complainant is arguably within the zone of interests to be protected or regulated by the statute or constitutional guarantee in question.
Page 431 - ... did not know and could not reasonably have been expected to know that the act ordered was unlawful.
Page 426 - evidence" to mean "substantial evidence," Washington, V. & M. Coach Co. v. Labor Board, 301 US 142, and we said that "[substantial evidence is more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.
Page 150 - ... provide such safeguards as may be necessary to assure that eligibility for care and services under the plan will be determined, and such care and services will be provided, in a manner consistent with simplicity of administration and the best interests of the recipients...
Page 153 - ... at the end of each contract year so as to assure that such organization is paid for the reasonable cost actually incurred (excluding therefrom any part of incurred cost found to be unnecessary in the efficient delivery of health services...
Page 163 - ... ripe" for judicial resolution. Without undertaking to survey the intricacies of the ripeness doctrine it is fair to say that its basic rationale is to prevent the courts, through avoidance of premature adjudication, from entangling themselves in abstract disagreements over administrative policies, and also to protect the agencies from judicial interference until an administrative decision has been formalized and its effects felt in a concrete way by the challenging parties.
Page 188 - ... could, consistent with the provision of appropriate medical care, be effectively provided on an outpatient basis or more economically in an inpatient health care facility of a different type.
Page 64 - Womer. chairman of the Council of Teaching Hospitals of the Association of American Medical Colleges, and director of Yale-New Haven Hospital.
Page 423 - ... (A) in the case of home health services (i) such services are or were required because the individual is or was confined to his home (except when receiving items and services referred to in section 1861 (m)( 7) ) and needed skilled nursing care on an intermittent basis, or physical or speech therapy...