The Code of Federal Regulations of the United States of AmericaU.S. Government Printing Office, 1989 The 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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Page 30
... month periods may not exceed the amount of Medicare payment that would otherwise have been made under the Medicare principles of reim- bursement for Medicare items and services had the State system not been in effect . States must ...
... month periods may not exceed the amount of Medicare payment that would otherwise have been made under the Medicare principles of reim- bursement for Medicare items and services had the State system not been in effect . States must ...
Page 33
... month period than would have otherwise been made under Medicare not using such system . If a State that has an ex- isting demonstration project in effect on April 20 , 1983 elects under $ 403.304 ( c ) ( 3 ) to have the effective- ness ...
... month period than would have otherwise been made under Medicare not using such system . If a State that has an ex- isting demonstration project in effect on April 20 , 1983 elects under $ 403.304 ( c ) ( 3 ) to have the effective- ness ...
Page 34
... month period beginning with the first month that the State system is operat- ing . For a State that has an existing demonstration project in effect on April 20 , 1983 , and that elects under § 403.304 ( c ) ( 3 ) to have a rate of in ...
... month period beginning with the first month that the State system is operat- ing . For a State that has an existing demonstration project in effect on April 20 , 1983 , and that elects under § 403.304 ( c ) ( 3 ) to have a rate of in ...
Page 35
... month period will exceed what Medicare would have paid : ( 2 ) Terminate the waiver ; and ( 3 ) Recoup overpayments to the af- fected hospitals in accordance with the procedures described in § 403.310 . § 403.321 State systems for ...
... month period will exceed what Medicare would have paid : ( 2 ) Terminate the waiver ; and ( 3 ) Recoup overpayments to the af- fected hospitals in accordance with the procedures described in § 403.310 . § 403.321 State systems for ...
Page 56
... month period has begun , as set forth in paragraph ( c ) of this section , Medicare benefits are secondary only for that portion of the 12 - month period that begins with the month of entitlement . ( 3 ) During the period in which Medi ...
... month period has begun , as set forth in paragraph ( c ) of this section , Medicare benefits are secondary only for that portion of the 12 - month period that begins with the month of entitlement . ( 3 ) During the period in which Medi ...
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Common terms and phrases
adjustment administrative agency agreement allowable cost amended amount amount in controversy applicable appropriate approved assets basis benefits carrier chapter clinic cluding coinsurance contract period cost reporting period coverage covered services deductible deter dialysis durable medical equipment eligible employees enrollment period entitled ESRD facility Federal filed HCFA health maintenance organization health services HMO's hospice care hospital's ices incurred individual initial determination interim intermediary items or services laboratory limits Medi Medicaid Medicare enrollees meet ment month nished notice nursing organiza organization outpatient paid party patient payment rates percent physi physical therapy physician premiums procedures prospective payment prospective payment system provider's qualified reasonable charge reasonable cost records Redesignated at 42 reim reimbursement renal renal dialysis reporting periods beginning request requirements Secretary Sept services furnished Social Security Act specified in paragraph speech pathology Standard Subpart supplier termination tient tion
Popular passages
Page 292 - 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 50 - Act with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made, under a workmen's compensation law or plan of the United States or a State.
Page 488 - Secretary determines to be reasonable, taking into account the range of interest rates prevailing in the private market for similar loans and the risks assumed by the United States...
Page 266 - ... (1) part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse...
Page 207 - ... (2) there will be interchange of medical and other information necessary or useful in the care and treatment of individuals transferred between the institutions, or in determining whether such individuals can be adequately cared for otherwise than in either of such institutions.
Page 127 - 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 353 - The objective is that under the methods of determining costs, the costs with respect to individuals covered by the program will not be borne by individuals not so covered, and the costs with respect to individuals not so covered will not be borne by the program.
Page 642 - ... a plan for furnishing^ such services to such individual has been established and is periodically reviewed by a physician; and such services are or were • furnished while the individual was under the care of a physician...
Page 557 - SEC. 207. (a) Section 201 of this title shall take effect on the first day of the first month following the month in which it is enacted.
Page 46 - ... (c) Eye examinations for the purpose of prescribing, fitting, or changing eyeglasses or contact lenses for refractive error only and procedures performed in the course of any eye examination to determine the refractive state of the eyes, without regard to the reason for the performance of the refractive procedures.