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 11
... paragraph ( b ) of 5 U.S.C. 552 , certain classes of records are exempt from disclosure . For some examples of the kinds of materials which are exempt , see Subpart F of the public information regulation of the Department of Health and ...
... paragraph ( b ) of 5 U.S.C. 552 , certain classes of records are exempt from disclosure . For some examples of the kinds of materials which are exempt , see Subpart F of the public information regulation of the Department of Health and ...
Page 23
... paragraph ( c ) of this section , the standards speci- fied in paragraph ( a ) of this section must be met in a single policy . ( c ) In the case of a nonprofit hospi- tal or a medical association where State law prohibits the inclusion ...
... paragraph ( c ) of this section , the standards speci- fied in paragraph ( a ) of this section must be met in a single policy . ( c ) In the case of a nonprofit hospi- tal or a medical association where State law prohibits the inclusion ...
Page 25
... paragraph ( a ) of this section ; and ( ii ) The information submitted to HCFA for review is accurate and com- plete and does not misrepresent any material fact . § 403.235 Review and certification of poli- cies . ( a ) HCFA will review ...
... paragraph ( a ) of this section ; and ( ii ) The information submitted to HCFA for review is accurate and com- plete and does not misrepresent any material fact . § 403.235 Review and certification of poli- cies . ( a ) HCFA will review ...
Page 35
... paragraph must- ( i ) Comply with the requirements of paragraphs ( b ) ( 3 ) and ( 5 ) of § 403.320 regarding a detailed description of the methodology used to derive the ex- penditure amounts : ( ii ) Include the data and assump- tions ...
... paragraph must- ( i ) Comply with the requirements of paragraphs ( b ) ( 3 ) and ( 5 ) of § 403.320 regarding a detailed description of the methodology used to derive the ex- penditure amounts : ( ii ) Include the data and assump- tions ...
Page 59
... paragraph ( a ) of this section shall be the amount he paid as specified in paragraph ( a ) ( 1 ) of this section , less the amount for deductibles and coinsurance , had such items or services been covered under the program . Any ...
... paragraph ( a ) of this section shall be the amount he paid as specified in paragraph ( a ) ( 1 ) of this section , less the amount for deductibles and coinsurance , had such items or services been covered under the program . Any ...
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Common terms and phrases
adjusted administrative agency agreement allowable cost amended amount amount in controversy applicable appropriate approved assets basis beneficiary benefits carrier chapter clinic cluding coinsurance contract period cost reporting period coverage covered services deductible dialysis durable medical equipment effective eligible employees enrollment period entitled ESRD facility Federal filed HCFA health maintenance organization health services HMO's hospice care hospital's ices individual 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 title XVIII
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.