Sample records for medicare program public

  1. 42 CFR 421.304 - Medicare integrity program contractor functions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services for which Medicare payment may be made either directly or indirectly. (b) Auditing, settling and.... 421.304 Section 421.304 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE CONTRACTING Medicare Integrity Program...

  2. 42 CFR 422.311 - RADV audit dispute and appeal processes.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false RADV audit dispute and appeal processes. 422.311 Section 422.311 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to Medicare Advantage...

  3. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159 Section 423.159 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

  4. 42 CFR 423.800 - Administration of subsidy program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Administration of subsidy program. 423.800 Section 423.800 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost...

  5. 42 CFR 422.1062 - Dismissal for cause.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Dismissal for cause. 422.1062 Section 422.1062 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money...

  6. 42 CFR 422.1062 - Dismissal for cause.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Dismissal for cause. 422.1062 Section 422.1062 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money...

  7. 42 CFR 422.1062 - Dismissal for cause.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Dismissal for cause. 422.1062 Section 422.1062 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money...

  8. 42 CFR 422.102 - Supplemental benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Supplemental benefits. 422.102 Section 422.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422.102...

  9. 42 CFR 422.1002 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Definitions. 422.1002 Section 422.1002 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422.1002...

  10. 78 FR 32664 - Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... Medicare, Medicaid and the Children's Health Insurance Program (CHIP). This meeting is open to the public... Health Insurance Program (CHIP). Enhancing the federal government's effectiveness in informing Medicare...

  11. 78 FR 12327 - Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). This meeting is open to the public... Health Insurance Program (CHIP). Enhancing the federal governments effectiveness in informing Medicare...

  12. 42 CFR 422.1006 - Appeal rights.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Appeal rights. 422.1006 Section 422.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422...

  13. 42 CFR 422.1006 - Appeal rights.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Appeal rights. 422.1006 Section 422.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422.1006 Appeal...

  14. 42 CFR 422.1062 - Dismissal for cause.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Dismissal for cause. 422.1062 Section 422.1062 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422...

  15. 42 CFR 422.1062 - Dismissal for cause.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Dismissal for cause. 422.1062 Section 422.1062 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422...

  16. 42 CFR 422.1006 - Appeal rights.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Appeal rights. 422.1006 Section 422.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422...

  17. 42 CFR 422.1006 - Appeal rights.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Appeal rights. 422.1006 Section 422.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422.1006 Appeal...

  18. 42 CFR 422.1006 - Appeal rights.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Appeal rights. 422.1006 Section 422.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422...

  19. 42 CFR 422.1092 - Revision of reopened decision.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Revision of reopened decision. 422.1092 Section 422.1092 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money...

  20. 42 CFR 422.212 - Limitations on provider indemnification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Limitations on provider indemnification. 422.212 Section 422.212 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Relationships With Providers § 422.212...

  1. Public financing of the Medicare program will make its uniform structure increasingly costly to sustain.

    PubMed

    Baicker, Katherine; Shepard, Mark; Skinner, Jonathan

    2013-05-01

    The US Medicare program consumes an ever-rising share of the federal budget. Although this public spending can produce health and social benefits, raising taxes to finance it comes at the cost of slower economic growth. In this article we describe a model incorporating the benefits of public programs and the cost of tax financing. The model implies that the "one-size-fits-all" Medicare program, with everyone covered by the same insurance policy, will be increasingly difficult to sustain. We show that a Medicare program with guaranteed basic benefits and the option to purchase additional coverage could lead to more unequal health spending but slower growth in taxation, greater overall well-being, and more rapid growth of gross domestic product. Our framework highlights the key trade-offs between Medicare spending and economic prosperity.

  2. 42 CFR 422.1092 - Revision of reopened decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Revision of reopened decision. 422.1092 Section 422.1092 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422...

  3. 42 CFR 422.402 - Federal preemption of State law.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Federal preemption of State law. 422.402 Section 422.402 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Organization Compliance With State Law and...

  4. 42 CFR 422.200 - Basis and scope.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Basis and scope. 422.200 Section 422.200 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Relationships With Providers § 422.200 Basis and scope. This...

  5. 42 CFR 422.118 - Confidentiality and accuracy of enrollee records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Confidentiality and accuracy of enrollee records. 422.118 Section 422.118 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary...

  6. 42 CFR 422.210 - Assurances to CMS.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Assurances to CMS. 422.210 Section 422.210 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Relationships With Providers § 422.210 Assurances to CMS. (a...

  7. 77 FR 17073 - Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). This meeting is open to the public... eligible for, Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Enhancing the Federal...

  8. 77 FR 37681 - Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-22

    ...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). This meeting is open to the public... eligible for, Medicare, Medicaid and the Children's Health Insurance Program (CHIP). Enhancing the Federal...

  9. 42 CFR 422.1094 - Notice and effect of revised decision.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Notice and effect of revised decision. 422.1094 Section 422.1094 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil...

  10. 42 CFR 422.1094 - Notice and effect of revised decision.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Notice and effect of revised decision. 422.1094 Section 422.1094 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money...

  11. 42 CFR 422.1018 - Notice and effect of initial determinations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Notice and effect of initial determinations. 422.1018 Section 422.1018 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money...

  12. 42 CFR 422.1094 - Notice and effect of revised decision.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Notice and effect of revised decision. 422.1094 Section 422.1094 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil...

  13. 42 CFR 422.1094 - Notice and effect of revised decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Notice and effect of revised decision. 422.1094 Section 422.1094 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money...

  14. 42 CFR 422.1018 - Notice and effect of initial determinations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Notice and effect of initial determinations. 422.1018 Section 422.1018 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money...

  15. 42 CFR 422.1094 - Notice and effect of revised decision.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Notice and effect of revised decision. 422.1094 Section 422.1094 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil...

  16. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

  17. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to...

  18. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

  19. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

  20. 42 CFR 422.2 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Definitions. 422.2 Section 422.2 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM General Provisions § 422.2 Definitions. As used in this part— Arrangement means a written agreement...

  1. 42 CFR 422.2 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Definitions. 422.2 Section 422.2 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM General Provisions § 422.2 Definitions. As used in this part— Arrangement means a written agreement...

  2. 42 CFR 422.2 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Definitions. 422.2 Section 422.2 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM General Provisions § 422.2 Definitions. As used in this part— Arrangement means a written agreement...

  3. 42 CFR 422.220 - Exclusion of services furnished under a private contract.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Exclusion of services furnished under a private contract. 422.220 Section 422.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Relationships With...

  4. 42 CFR 422.214 - Special rules for services furnished by noncontract providers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for services furnished by noncontract providers. 422.214 Section 422.214 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Relationships With...

  5. Public Financing Of The Medicare Program Will Make Its Uniform Structure Increasingly Costly To Sustain

    PubMed Central

    Baicker, Katherine; Shepard, Mark; Skinner, Jonathan

    2013-01-01

    The US Medicare program consumes an ever-rising share of the federal budget. Although this public spending can produce health and social benefits, raising taxes to finance it comes at the cost of slower economic growth. In this article we describe a model incorporating the benefits of public programs and the cost of tax financing. The model implies that the “one-size-fits-all” Medicare program, with everyone covered by the same insurance policy, will be increasingly difficult to sustain. We show that a Medicare program with guaranteed basic benefits and the option to purchase additional coverage could lead to more unequal health spending but slower growth in taxation, greater overall well-being, and more rapid growth of gross domestic product. Our framework highlights the key trade-offs between Medicare spending and economic prosperity. PMID:23650321

  6. 42 CFR 425.204 - Content of the application.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Content of the application. 425.204 Section 425.204 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE SHARED SAVINGS PROGRAM Application Procedures and Participation Agreement § 425.204 Content of the...

  7. 42 CFR 422.105 - Special rules for self-referral and point of service option.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for self-referral and point of service option. 422.105 Section 422.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and...

  8. 42 CFR 422.2 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Definitions. 422.2 Section 422.2 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM General Provisions § 422.2 Definitions. As used in this part— Arrangement means a written agreement between an MA...

  9. 42 CFR 422.158 - Procedures for approval of accreditation as a basis for deeming compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Procedures for approval of accreditation as a basis for deeming compliance. 422.158 Section 422.158 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Quality...

  10. 42 CFR 405.809 - Opportunity to submit evidence.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Opportunity to submit evidence. 405.809 Section 405.809 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Appeals Under the Medicare Part B Program § 405.809 Opportunity to submit...

  11. 42 CFR 405.410 - Conditions for properly opting-out of Medicare.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Conditions for properly opting-out of Medicare. 405.410 Section 405.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts...

  12. 42 CFR 405.455 - Application to Medicare+Choice contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Application to Medicare+Choice contracts. 405.455 Section 405.455 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.455...

  13. 42 CFR 405.377 - Withholding Medicare payments to recover Medicaid overpayments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Withholding Medicare payments to recover Medicaid overpayments. 405.377 Section 405.377 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  14. 42 CFR 405.377 - Withholding Medicare payments to recover Medicaid overpayments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Withholding Medicare payments to recover Medicaid overpayments. 405.377 Section 405.377 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  15. 77 FR 26553 - Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel-May 21, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-04

    ...] Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel--May 21, 2012 AGENCY... announces that a public meeting of the Medicare Economic Index Technical Advisory Panel (``the Panel'') will... Economic Index (MEI). This first meeting will focus on MEI inputs and input weights. This meeting is open...

  16. 42 CFR 405.425 - Effects of opting-out of Medicare.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Effects of opting-out of Medicare. 405.425 Section 405.425 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.425...

  17. 42 CFR 406.7 - Forms to apply for entitlement under Medicare Part A.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... supplementary medical insurance program.) CMS-43—Application for Health Insurance Benefits under Medicare for... 42 Public Health 2 2010-10-01 2010-10-01 false Forms to apply for entitlement under Medicare Part A. 406.7 Section 406.7 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  18. 75 FR 76471 - Medicare Program; Renewal of the Medicare Evidence Development & Coverage Advisory Committee...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... economics of health care, medical ethics and other related professions such as epidemiology and... basis. The MEDCAC--(1) Hears public testimony; (2) reviews medical literature, technology assessments... Federal Domestic Assistance Program No. 93.774, Medicare--Supplementary Medical Insurance Program). Dated...

  19. 42 CFR 423.150 - Scope.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Scope. 423.150 Section 423.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements...

  20. 42 CFR 423.168 - Accreditation organizations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Accreditation organizations. 423.168 Section 423.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

  1. 75 FR 71064 - Medicare Program; Proposed Changes to the Medicare Advantage and the Medicare Prescription Drug...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... and the Medicare Prescription Drug Benefit Programs for Contract Year 2012 and Other Proposed Changes... for Contract Year 2012 and Other Proposed Changes'' which was filed for public inspection on November 10, 2010. FOR FURTHER INFORMATION CONTACT: Sabrina Ahmed, (410) 786-7499. SUPPLEMENTARY INFORMATION...

  2. 42 CFR 414.908 - Competitive acquisition program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... (J) Beneficiary Medicare information/Health insurance (HIC) number. (K) Supplementary insurance... 42 Public Health 3 2011-10-01 2011-10-01 false Competitive acquisition program. 414.908 Section 414.908 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  3. 42 CFR 414.908 - Competitive acquisition program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... (J) Beneficiary Medicare information/Health insurance (HIC) number. (K) Supplementary insurance... 42 Public Health 3 2010-10-01 2010-10-01 false Competitive acquisition program. 414.908 Section 414.908 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  4. 42 CFR 405.371 - Suspension, offset, and recoupment of Medicare payments to providers and suppliers of services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Suspension, offset, and recoupment of Medicare payments to providers and suppliers of services. 405.371 Section 405.371 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR...

  5. 42 CFR 405.371 - Suspension, offset, and recoupment of Medicare payments to providers and suppliers of services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Suspension, offset, and recoupment of Medicare payments to providers and suppliers of services. 405.371 Section 405.371 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR...

  6. 42 CFR 423.1006 - Appeal rights.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Appeal rights. 423.1006 Section 423.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money...

  7. 42 CFR 423.1006 - Appeal rights.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Appeal rights. 423.1006 Section 423.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money...

  8. 42 CFR 423.1006 - Appeal rights.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Appeal rights. 423.1006 Section 423.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money Penalties...

  9. 42 CFR 423.1006 - Appeal rights.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Appeal rights. 423.1006 Section 423.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money Penalties...

  10. 42 CFR 423.1006 - Appeal rights.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Appeal rights. 423.1006 Section 423.1006 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money...

  11. 42 CFR 423.156 - Consumer satisfaction surveys.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Consumer satisfaction surveys. 423.156 Section 423.156 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

  12. 42 CFR 423.162 - Quality improvement organization activities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Quality improvement organization activities. 423.162 Section 423.162 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control...

  13. 42 CFR 423.774 - Eligibility determinations, redeterminations, and applications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Eligibility determinations, redeterminations, and applications. 423.774 Section 423.774 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT...

  14. 42 CFR 422.2260 - Definitions concerning marketing materials.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Definitions concerning marketing materials. 422... HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Medicare Advantage Marketing Requirements § 422.2260 Definitions concerning marketing materials. As used in this subpart— Marketing...

  15. 42 CFR 423.1062 - Dismissal for cause.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Dismissal for cause. 423.1062 Section 423.1062 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money...

  16. 42 CFR 423.1062 - Dismissal for cause.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Dismissal for cause. 423.1062 Section 423.1062 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money...

  17. 42 CFR 423.160 - Standards for electronic prescribing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Standards for electronic prescribing. 423.160 Section 423.160 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

  18. 42 CFR 423.773 - Requirements for eligibility.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements for eligibility. 423.773 Section 423.773 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost-Sharing Subsidies...

  19. 42 CFR 423.1014 - Charge for transcripts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Charge for transcripts. 423.1014 Section 423.1014 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money...

  20. 42 CFR 423.1046 - Conduct of hearing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conduct of hearing. 423.1046 Section 423.1046 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money...

  1. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Exclusion from participation in Medicare, Medicaid..., ASSESSMENTS AND EXCLUSIONS § 1003.105 Exclusion from participation in Medicare, Medicaid and all Federal... the Medicare and Medicaid programs, he or she will, at the same time he or she notifies the respondent...

  2. 75 FR 76468 - Office of the Assistant Secretary for Planning and Evaluation; Medicare Program; Meeting of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... Evaluation; Medicare Program; Meeting of the Technical Advisory Panel on Medicare Trustee Reports AGENCY... announces a public meeting of the Technical Advisory Panel on Medicare Trustee Reports (Panel). Notice of... long run. The Panel's discussion is expected to be very technical in nature and will focus on the...

  3. 42 CFR 422.2276 - Employer group retiree marketing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Employer group retiree marketing. 422.2276 Section... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Medicare Advantage Marketing Requirements § 422.2276 Employer group retiree marketing. MA organizations may develop marketing materials designed...

  4. 42 CFR 422.2276 - Employer group retiree marketing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Employer group retiree marketing. 422.2276 Section... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Medicare Advantage Marketing Requirements § 422.2276 Employer group retiree marketing. MA organizations may develop marketing materials...

  5. 42 CFR 422.2276 - Employer group retiree marketing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Employer group retiree marketing. 422.2276 Section... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Medicare Advantage Marketing Requirements § 422.2276 Employer group retiree marketing. MA organizations may develop marketing materials...

  6. 42 CFR 422.2276 - Employer group retiree marketing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Employer group retiree marketing. 422.2276 Section... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Medicare Advantage Marketing Requirements § 422.2276 Employer group retiree marketing. MA organizations may develop marketing materials...

  7. 42 CFR 460.68 - Program integrity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Program integrity. 460.68 Section 460.68 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... of criminal offenses related to their involvement in Medicaid, Medicare, other health insurance or...

  8. 42 CFR 460.68 - Program integrity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Program integrity. 460.68 Section 460.68 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... of criminal offenses related to their involvement in Medicaid, Medicare, other health insurance or...

  9. 42 CFR 460.68 - Program integrity.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Program integrity. 460.68 Section 460.68 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... of criminal offenses related to their involvement in Medicaid, Medicare, other health insurance or...

  10. 42 CFR 460.68 - Program integrity.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Program integrity. 460.68 Section 460.68 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... of criminal offenses related to their involvement in Medicaid, Medicare, other health insurance or...

  11. 42 CFR 460.68 - Program integrity.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Program integrity. 460.68 Section 460.68 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... of criminal offenses related to their involvement in Medicaid, Medicare, other health insurance or...

  12. 42 CFR 423.1092 - Revision of reopened decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Revision of reopened decision. 423.1092 Section 423.1092 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Appeal Procedures for Civil Money...

  13. 42 CFR 423.104 - Requirements related to qualified prescription drug coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements related to qualified prescription drug coverage. 423.104 Section 423.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT...

  14. 42 CFR 423.771 - Basis and scope.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Basis and scope. 423.771 Section 423.771 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost-Sharing Subsidies for Low...

  15. 42 CFR 423.886 - Retiree drug subsidy amounts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Retiree drug subsidy amounts. 423.886 Section 423.886 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree...

  16. 42 CFR 422.404 - State premium taxes prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....404 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Organization Compliance With State Law and Preemption by Federal Law § 422.404 State premium taxes prohibited. (a) Basic rule. No premium tax, fee, or...

  17. 42 CFR 405.809 - Opportunity to submit evidence.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Opportunity to submit evidence. 405.809 Section 405.809 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Appeals Under the Medicare Part B...

  18. 42 CFR 423.165 - Compliance deemed on the basis of accreditation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Compliance deemed on the basis of accreditation. 423.165 Section 423.165 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost...

  19. 42 CFR 423.2110 - MAC reviews on its own motion.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false MAC reviews on its own motion. 423.2110 Section 423.2110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review...

  20. 42 CFR 423.2276 - Employer group retiree marketing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Employer group retiree marketing. 423.2276 Section 423.2276 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Part D Marketing Requirements § 423.2276 Employer group retiree...

  1. 42 CFR 422.2262 - Review and distribution of marketing materials.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Review and distribution of marketing materials. 422... HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Medicare Advantage Marketing Requirements § 422.2262 Review and distribution of marketing materials. (a) CMS review of marketing materials...

  2. 42 CFR 403.322 - Termination of agreements for Medicare recognition of State systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Termination of agreements for Medicare recognition of State systems. 403.322 Section 403.322 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Recognition of State...

  3. 42 CFR 423.2272 - Licensing of marketing representatives and confirmation of marketing resources.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Licensing of marketing representatives and confirmation of marketing resources. 423.2272 Section 423.2272 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Part D Marketing...

  4. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions...

  5. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions...

  6. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions...

  7. 42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...

  8. 42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...

  9. 42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...

  10. 42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...

  11. 42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...

  12. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2011-10-01 2011-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality improvement...

  13. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., psychosocial, or clinical domains (for example, quality of life indicators, depression scales, or chronic... 42 Public Health 3 2010-10-01 2010-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality improvement...

  14. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2014-10-01 2014-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...

  15. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2012-10-01 2012-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...

  16. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2013-10-01 2013-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...

  17. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions. For purposes of this...

  18. 42 CFR 405.2442 - Notice to the public.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Notice to the public. 405.2442 Section 405.2442 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  19. 42 CFR 412.8 - Publication of schedules for determining prospective payment rates.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Publication of schedules for determining prospective payment rates. 412.8 Section 412.8 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL...

  20. Your Medicare Benefits

    MedlinePlus

    ... health plans include all Medicare Advantage Plans, Medicare Cost Plans, and Demonstration/Pilot Programs. PACE plans can be offered by public or private entities and provide Part D and other benefits in addition to Part A and Part B ...

  1. 42 CFR 412.110 - Total Medicare payment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Payments to Hospitals Under the Prospective Payment Systems § 412.110 Total Medicare payment. Under the prospective payment systems, Medicare... 42 Public Health 2 2010-10-01 2010-10-01 false Total Medicare payment. 412.110 Section 412.110...

  2. 42 CFR 422.4 - Types of MA plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Types of MA plans. 422.4 Section 422.4 Public...) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM General Provisions § 422.4 Types of MA plans. (a) General rule. An MA plan may be a coordinated care plan, a combination of an MA MSA plan and a contribution into an...

  3. 42 CFR 422.4 - Types of MA plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Types of MA plans. 422.4 Section 422.4 Public...) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM General Provisions § 422.4 Types of MA plans. (a) General rule. An MA plan may be a coordinated care plan, a combination of an MA MSA plan and a...

  4. 42 CFR 422.4 - Types of MA plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Types of MA plans. 422.4 Section 422.4 Public...) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM General Provisions § 422.4 Types of MA plans. (a) General rule. An MA plan may be a coordinated care plan, a combination of an MA MSA plan and a...

  5. 42 CFR 422.4 - Types of MA plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Types of MA plans. 422.4 Section 422.4 Public...) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM General Provisions § 422.4 Types of MA plans. (a) General rule. An MA plan may be a coordinated care plan, a combination of an MA MSA plan and a...

  6. 42 CFR 480.137 - Disclosure to Federal and State enforcement agencies responsible for the investigation or...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... agencies responsible for the investigation or identification of fraud or abuse of the Medicare or Medicaid programs. 480.137 Section 480.137 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Medicare or Medicaid programs. (a) Required disclosure. Except as specified in §§ 480.139(a) and 480.140...

  7. Compendia and anticancer therapy under Medicare.

    PubMed

    Tillman, Katherine; Burton, Brijet; Jacques, Louis B; Phurrough, Steve E

    2009-03-03

    In 1993, Congress directed the Medicare program to refer to 3 existing published compendia, American Medical Association Drug Evaluations (AMA-DE), United States Pharmacopoeia Drug Information for the Health Professional (USP-DI), and American Hospital Formulary Service Drug Information (AHFS-DI), to identify unlabeled but medically accepted uses of drugs and biologicals in anticancer chemotherapy regimens. Public discussion during the preceding years had centered on whether to designate unlabeled uses of anticancer treatments as experimental and thus outside the scope of Medicare benefits. American Medical Association Drug Evaluations and USP-DI subsequently ceased publication, and the Medicare program faced increasing calls to revise the list of acceptable compendia, as authorized in the statute. In 2007, the Centers for Medicare & Medicaid Services used its regulatory authority to establish a publicly transparent process to revise the list. The Centers for Medicare & Medicaid Services considered 5 requests in 2008 and added National Comprehensive Cancer Network Drugs and Biologics Compendium, DRUGDEX, and Clinical Pharmacology to the list of compendia. DrugPoints was not added, and AMA-DE was removed. Because of the potential for conflicts of interest to lead to biased judgments, the 2008 Medicare Improvements for Patients and Providers Act has a provision that explicitly prohibits inclusion of compendia that do not have a publicly transparent process for evaluating therapies and identifying potential conflicts of interest.

  8. 78 FR 53769 - Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and..., Medicaid and the Children's Health Insurance Program (CHIP). This meeting is open to the public. DATES... Children's Health Insurance Program (CHIP). Enhancing the federal government's effectiveness in informing...

  9. 42 CFR 414.620 - Publication of the ambulance fee schedule.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 414.620 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedule for Ambulance Services § 414.620 Publication of the ambulance fee schedule. Changes in payment rates resulting...

  10. 42 CFR 1001.301 - Conviction relating to obstruction of an investigation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... investigation. 1001.301 Section 1001.301 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS... the Medicare, Medicaid or other Federal health care programs; (iii) The interference or obstruction...

  11. 42 CFR 1001.301 - Conviction relating to obstruction of an investigation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... investigation. 1001.301 Section 1001.301 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS... the Medicare, Medicaid or other Federal health care programs; (iii) The interference or obstruction...

  12. 42 CFR 1001.301 - Conviction relating to obstruction of an investigation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... investigation. 1001.301 Section 1001.301 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS... the Medicare, Medicaid or other Federal health care programs; (iii) The interference or obstruction...

  13. 42 CFR 1001.301 - Conviction relating to obstruction of an investigation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... investigation. 1001.301 Section 1001.301 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS... the Medicare, Medicaid or other Federal health care programs; (iii) The interference or obstruction...

  14. 42 CFR 417.911 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Definitions. 417.911 Section 417.911 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE...

  15. 42 CFR 417.911 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Definitions. 417.911 Section 417.911 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE...

  16. 42 CFR 417.911 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Definitions. 417.911 Section 417.911 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS...

  17. 42 CFR 417.911 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Definitions. 417.911 Section 417.911 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS...

  18. 42 CFR 417.911 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Definitions. 417.911 Section 417.911 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE...

  19. 42 CFR 408.205 - Application procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Application procedures. 408.205 Section 408.205 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Supplementary Medical Insurance Premium Surcharge...

  20. 42 CFR 408.205 - Application procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Application procedures. 408.205 Section 408.205 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Supplementary Medical Insurance Premium Surcharge...

  1. 42 CFR 423.466 - Timeframes for coordination of benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 423.466 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D...) Retroactive claims adjustments, underpayment refunds, and overpayment recoveries. Whenever a sponsor receives...

  2. 42 CFR 405.1801 - Introduction.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Introduction. 405.1801 Section 405.1801 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM....1801 Introduction. (a) Definitions. As used in this subpart: Administrator means the Administrator or...

  3. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  4. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  5. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  6. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  7. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  8. 42 CFR 418.114 - Condition of participation: Personnel qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Condition of participation: Personnel qualifications. 418.114 Section 418.114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of participation...

  9. 42 CFR 412.98 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false [Reserved] 412.98 Section 412.98 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the...

  10. 42 CFR 418.114 - Condition of participation: Personnel qualifications.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Condition of participation: Personnel qualifications. 418.114 Section 418.114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  11. 42 CFR 418.114 - Condition of participation: Personnel qualifications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Condition of participation: Personnel qualifications. 418.114 Section 418.114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  12. 42 CFR 418.114 - Condition of participation: Personnel qualifications.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Condition of participation: Personnel qualifications. 418.114 Section 418.114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  13. 42 CFR 410.143 - Requirements for approved accreditation organizations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Requirements for approved accreditation organizations. 410.143 Section 410.143 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient...

  14. 42 CFR 410.143 - Requirements for approved accreditation organizations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Requirements for approved accreditation organizations. 410.143 Section 410.143 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient...

  15. 42 CFR 410.100 - Included services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Included services. 410.100 Section 410.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Comprehensive Outpatient Rehabilitation Facility (CORF) Services...

  16. 42 CFR 410.102 - Excluded services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Excluded services. 410.102 Section 410.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Comprehensive Outpatient Rehabilitation Facility (CORF) Services...

  17. 42 CFR 417.548 - Provider services through arrangements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Provider services through arrangements. 417.548 Section 417.548 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND...

  18. 42 CFR 422.566 - Organization determinations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Organization determinations. 422.566 Section 422... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Grievances, Organization Determinations and Appeals § 422.566 Organization determinations. (a) Responsibilities of the MA organization. Each MA organization...

  19. 78 FR 31560 - Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test Payment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... announces a public meeting to receive comments and recommendations (including accompanying data on which recommendations are based) from the public on the appropriate basis for establishing payment amounts for new or substantially revised Healthcare Common Procedure Coding System (HCPCS) codes being considered for Medicare...

  20. 77 FR 31620 - Medicare Program; Public Meeting in Calendar Year 2012 for New Clinical Laboratory Tests Payment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... announces a public meeting to receive comments and recommendations from the public on the appropriate basis... System (HCPCS) codes being considered for Medicare payment under the clinical laboratory fee schedule... the Federal Register notice of a meeting to receive comments and recommendations (and data on which...

  1. Patents, Innovation, and the Welfare Effects of Medicare Part D*

    PubMed Central

    Gailey, Adam; Lakdawalla, Darius; Sood, Neeraj

    2013-01-01

    Purpose To evaluate the efficiency consequences of the Medicare Part D program. Methods We develop and empirically calibrate a simple theoretical model to examine the static and dynamic welfare effects of Medicare Part D. Findings We show that Medicare Part D can simultaneously reduce static deadweight loss from monopoly pricing of drugs and improve incentives for innovation. We estimate that even after excluding the insurance value of the program, the welfare gain of Medicare Part D roughly equals its social costs. The program generates $5.11 billion of annual static deadweight loss reduction, and at least $3.0 billion of annual value from extra innovation. Implications Medicare Part D and other public prescription drug programs can be welfare-improving, even for risk-neutral and purely self-interested consumers. Furthermore, negotiation for lower branded drug prices may further increase the social return to the program. Originality This study demonstrates that pure efficiency motives, which do not even surface in the policy debate over Medicare Part D, can nearly justify the program on their own merits. PMID:20575239

  2. 42 CFR 408.65 - Payment options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment options. 408.65 Section 408.65 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Individual Payment § 408.65 Payment options...

  3. 42 CFR 405.1863 - Administrative policy at issue.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Administrative policy at issue. 405.1863 Section 405.1863 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Provider Reimbursement...

  4. 42 CFR 405.1863 - Administrative policy at issue.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Administrative policy at issue. 405.1863 Section 405.1863 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Provider Reimbursement...

  5. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  6. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS...

  7. 42 CFR 417.105 - Payment for supplemental health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for supplemental health services. 417.105 Section 417.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  8. 42 CFR 417.105 - Payment for supplemental health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Payment for supplemental health services. 417.105 Section 417.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  9. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  10. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  11. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  12. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS...

  13. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS...

  14. 42 CFR 417.105 - Payment for supplemental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for supplemental health services. 417.105 Section 417.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND...

  15. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  16. 42 CFR 414.504 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false [Reserved] 414.504 Section 414.504 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic...

  17. 42 CFR 414.100 - Purpose.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Purpose. 414.100 Section 414.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for Parenteral and...

  18. 42 CFR 409.46 - Allowable administrative costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Allowable administrative costs. 409.46 Section 409.46 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.46...

  19. 42 CFR 410.130 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Definitions. 410.130 Section 410.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.130 Definitions. For the purposes...

  20. 42 CFR 414.100 - Purpose.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Purpose. 414.100 Section 414.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for Parenteral and Enteral...

  1. 42 CFR 414.100 - Purpose.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Purpose. 414.100 Section 414.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for Parenteral and...

  2. 42 CFR 414.100 - Purpose.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Purpose. 414.100 Section 414.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for Parenteral and Enteral...

  3. 42 CFR 410.130 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Definitions. 410.130 Section 410.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.130 Definitions. For the purposes...

  4. 42 CFR 414.100 - Purpose.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Purpose. 414.100 Section 414.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for Parenteral and...

  5. 42 CFR 410.130 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Definitions. 410.130 Section 410.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.130 Definitions. For the purposes...

  6. 42 CFR 409.46 - Allowable administrative costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Allowable administrative costs. 409.46 Section 409.46 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.46...

  7. 42 CFR 409.46 - Allowable administrative costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Allowable administrative costs. 409.46 Section 409.46 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.46...

  8. 42 CFR 410.130 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Definitions. 410.130 Section 410.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.130 Definitions. For the purposes...

  9. 42 CFR 405.2402 - Basic requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Basic requirements. 405.2402 Section 405.2402 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  10. 42 CFR 405.2412 - Physicians' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Physicians' services. 405.2412 Section 405.2412 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  11. 42 CFR 405.2430 - Basic requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Basic requirements. 405.2430 Section 405.2430 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  12. 42 CFR 405.2400 - Basis.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Basis. 405.2400 Section 405.2400 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified Health Center...

  13. 42 CFR 405.370 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Definitions. 405.370 Section 405.370 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment, Recovery of Overpayments, and Repayment...

  14. 42 CFR 405.370 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Definitions. 405.370 Section 405.370 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment, Recovery of Overpayments, and Repayment...

  15. 42 CFR 418.104 - Condition of participation: Clinical records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition of participation: Clinical records. 418.104 Section 418.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of participation: Organizational...

  16. 42 CFR 418.104 - Condition of participation: Clinical records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Condition of participation: Clinical records. 418.104 Section 418.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of participation: Organizational...

  17. 42 CFR 418.102 - Condition of participation: Medical director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Condition of participation: Medical director. 418.102 Section 418.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of participation: Organizational...

  18. 42 CFR 418.102 - Condition of participation: Medical director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition of participation: Medical director. 418.102 Section 418.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of participation: Organizational...

  19. 42 CFR 412.70 - General description.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false General description. 412.70 Section 412.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Determination of Transition Period Payment Rates...

  20. 42 CFR 412.90 - General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false General rules. 412.90 Section 412.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the...

  1. 42 CFR 409.3 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Definitions. 409.3 Section 409.3 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Hospital Insurance Benefits: General Provisions § 409.3 Definitions. As used in...

  2. 42 CFR 409.82 - Inpatient hospital deductible.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Inpatient hospital deductible. 409.82 Section 409.82 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Hospital Insurance Deductibles and Coinsurance § 409.82...

  3. 42 CFR 409.83 - Inpatient hospital coinsurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Inpatient hospital coinsurance. 409.83 Section 409.83 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Hospital Insurance Deductibles and Coinsurance § 409.83...

  4. 42 CFR 418.78 - Conditions of participation-Volunteers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conditions of participation-Volunteers. 418.78 Section 418.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of Participation: Patient Care Non-Core...

  5. 42 CFR 417.484 - Requirement applicable to related entities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Requirement applicable to related entities. 417.484 Section 417.484 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  6. 42 CFR 417.484 - Requirement applicable to related entities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Requirement applicable to related entities. 417.484 Section 417.484 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  7. 42 CFR 422.102 - Supplemental benefits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Supplemental benefits. 422.102 Section 422.102... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422.102 Supplemental benefits. (a) Mandatory supplemental benefits. (1) Subject to CMS approval, an MA...

  8. 42 CFR 422.102 - Supplemental benefits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Supplemental benefits. 422.102 Section 422.102... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422.102 Supplemental benefits. (a) Mandatory supplemental benefits. (1) Subject to CMS approval, an MA...

  9. 42 CFR 422.102 - Supplemental benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Supplemental benefits. 422.102 Section 422.102... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422.102 Supplemental benefits. (a) Mandatory supplemental benefits. (1) Subject to CMS approval, an MA...

  10. 42 CFR 403.310 - Reduction in payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Recognition of State Reimbursement Control Systems § 403.310... amount by which the Medicare payments under the system exceed the amount of Medicare payments to such...

  11. 75 FR 73090 - Medicare Program; Listening Session on Development of Additional Imaging Efficiency Measures for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-29

    ... Hospital Outpatient Quality Data Reporting Program AGENCY: Centers for Medicare & Medicaid Services (CMS... Quality Data Reporting Program (HOP QDRP), which is authorized under section 1833(t)(17) of the Social... participate either in person or via teleconference. The meeting is open to the public, but attendance is...

  12. Medicare's chronic care improvement pilot program: what is its potential?

    PubMed

    Super, Nora

    2004-05-10

    This paper describes the voluntary chronic care improvement program under traditional fee-for-service Medicare as authorized by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Public Law 108-173; section 721). This brief analyzes the emerging issues raised by this new program, including which chronic conditions and regional areas will be targeted, the types of entities that may participate, the physician's role in care management, and the adoption and use of health information technology and evidence-based clinical guidelines.

  13. 42 CFR 423.1976 - Judicial review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Judicial review. 423.1976 Section 423.1976 Public...) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.1976 Judicial review. (a) Review of ALJ's decision. The enrollee may request judicial...

  14. 42 CFR 414.918 - Assignment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Assignment. 414.918 Section 414.918 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals Under Part...

  15. 42 CFR 414.910 - Bidding process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Bidding process. 414.910 Section 414.910 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals...

  16. 42 CFR 414.920 - Judicial review.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Judicial review. 414.920 Section 414.920 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals...

  17. 42 CFR 414.920 - Judicial review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Judicial review. 414.920 Section 414.920 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals...

  18. 42 CFR 414.918 - Assignment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Assignment. 414.918 Section 414.918 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals Under Part...

  19. 42 CFR 414.910 - Bidding process.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Bidding process. 414.910 Section 414.910 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals...

  20. 42 CFR 405.745 - Amount in controversy ascertained after reconsideration.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Amount in controversy ascertained after reconsideration. 405.745 Section 405.745 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED...

  1. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS...

  2. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS...

  3. 42 CFR 414.102 - General payment rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false General payment rules. 414.102 Section 414.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for...

  4. 42 CFR 414.102 - General payment rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false General payment rules. 414.102 Section 414.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for...

  5. 42 CFR 414.106 - Splints and casts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Splints and casts. 414.106 Section 414.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for...

  6. 42 CFR 414.102 - General payment rules.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false General payment rules. 414.102 Section 414.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

  7. 42 CFR 414.102 - General payment rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false General payment rules. 414.102 Section 414.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

  8. 42 CFR 405.400 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Definitions. 405.400 Section 405.400 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.400 Definitions. For purposes of this...

  9. 42 CFR 414.102 - General payment rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false General payment rules. 414.102 Section 414.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

  10. 42 CFR 405.400 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Definitions. 405.400 Section 405.400 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.400 Definitions. For purposes of this...

  11. 42 CFR 405.2404 - Terminations of agreements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Terminations of agreements. 405.2404 Section 405.2404 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally...

  12. 42 CFR 405.2436 - Termination of agreement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Termination of agreement. 405.2436 Section 405.2436 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  13. 42 CFR 405.450 - Appeals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Appeals. 405.450 Section 405.450 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.450 Appeals. (a) A determination by...

  14. 42 CFR 405.2444 - Change of ownership.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Change of ownership. 405.2444 Section 405.2444 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  15. 42 CFR 405.400 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Definitions. 405.400 Section 405.400 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.400 Definitions. For purposes of this...

  16. 42 CFR 405.2102 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Definitions. 405.2102 Section 405.2102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End-Stage Renal...

  17. 42 CFR 405.2114 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false [Reserved] 405.2114 Section 405.2114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End-Stage Renal...

  18. 42 CFR 405.2114 - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false [Reserved] 405.2114 Section 405.2114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End-Stage Renal...

  19. 42 CFR 405.2111 - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false [Reserved] 405.2111 Section 405.2111 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End-Stage Renal...

  20. 42 CFR 405.374 - Opportunity for rebuttal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Opportunity for rebuttal. 405.374 Section 405.374 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment, Recovery of Overpayments...

  1. 42 CFR 405.374 - Opportunity for rebuttal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Opportunity for rebuttal. 405.374 Section 405.374 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment, Recovery of Overpayments...

  2. 42 CFR 405.2111 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false [Reserved] 405.2111 Section 405.2111 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End-Stage Renal...

  3. 42 CFR 418.108 - Condition of participation: Short-term inpatient care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Condition of participation: Short-term inpatient care. 418.108 Section 418.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of participation...

  4. 42 CFR 414.912 - Conflicts of interest

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conflicts of interest 414.912 Section 414.912 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and...

  5. 42 CFR 414.912 - Conflicts of interest

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Conflicts of interest 414.912 Section 414.912 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and...

  6. 42 CFR 418.108 - Condition of participation: Short-term inpatient care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition of participation: Short-term inpatient care. 418.108 Section 418.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of participation...

  7. 42 CFR 417.423 - Special rules: ESRD and hospice patients.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules: ESRD and hospice patients. 417.423 Section 417.423 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND...

  8. 42 CFR 418.108 - Condition of participation: Short-term inpatient care.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Condition of participation: Short-term inpatient care. 418.108 Section 418.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  9. 42 CFR 418.108 - Condition of participation: Short-term inpatient care.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Condition of participation: Short-term inpatient care. 418.108 Section 418.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  10. 42 CFR 418.108 - Condition of participation: Short-term inpatient care.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Condition of participation: Short-term inpatient care. 418.108 Section 418.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  11. 42 CFR 409.41 - Requirement for payment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Requirement for payment. 409.41 Section 409.41 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.41 Requirement for...

  12. 42 CFR 410.20 - Physicians' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Physicians' services. 410.20 Section 410.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.20 Physicians' services...

  13. 42 CFR 409.80 - Inpatient deductible and coinsurance: General provisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Inpatient deductible and coinsurance: General provisions. 409.80 Section 409.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Hospital Insurance Deductibles and...

  14. 42 CFR 409.2 - Scope.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Scope. 409.2 Section 409.2 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Hospital Insurance Benefits: General Provisions § 409.2 Scope. Subparts A through G of...

  15. 42 CFR 405.902 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... physical therapy or speech pathology services, or a community mental health center that has in effect a... 42 Public Health 2 2010-10-01 2010-10-01 false Definitions. 405.902 Section 405.902 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL...

  16. 42 CFR 408.80 - Basic rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Basic rules. 408.80 Section 408.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.80 Basic rules. (a...

  17. 42 CFR 410.105 - Requirements for coverage of CORF services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements for coverage of CORF services. 410.105 Section 410.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Comprehensive Outpatient...

  18. Coordination of health coverage for Medicare enrollees: living with HIV/AIDS in California.

    PubMed

    Eichner, J; Kahn, J G

    2001-08-01

    Because Medicare does not cover a large part of the health care that its enrollees living with HIV/AIDS require, they need other coverage to supplement Medicare. Medicaid is a major source of that supplemental coverage. In California, Medicare enrollees with HIV/AIDS who were also enrolled in Medi-Cal (California's Medicaid program) had total payments from both programs of $177 million, or an average of $28,956 per person in the fee-for-service-system in 1998. Of that total, Medicare paid for 38 percent, mainly for inpatient visits and ambulatory care, while Medi-Cal paid 62 percent, mainly for prescription drugs. For these dual enrollees, many of Medicare's benefit gaps--including a large share of prescription drugs, nursing facility services and home care--are being filled by Medi-Cal. Data in this Medicare Brief indicate that the incremental cost to the federal government of filling gaps in the Medicare benefits package would be considerably less than the full cost of the additional benefits. Through Medicaid and other programs, the federal government is already paying a substantial part of public program expenditures for dual enrollees with HIV/AIDS. Other issues to consider are how the dual Medicare-Medicaid funding streams affect the programs' cost efficiency, and from the perspective of Medicare enrollees and providers, how well the dual programs coordinate to meet the needs of people with HIV/AIDS and other chronic conditions.

  19. 42 CFR § 510.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

    Code of Federal Regulations, 2010 CFR

    2017-10-01

    ... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2017-10-01 2017-10-01 false Treatment of incentive programs or add-on payments...

  20. 42 CFR § 510.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

    Code of Federal Regulations, 2010 CFR

    2016-10-01

    ... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2016-10-01 2016-10-01 false Treatment of incentive programs or add-on payments...

  1. 42 CFR 423.2136 - Judicial review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Judicial review. 423.2136 Section 423.2136 Public...) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2136 Judicial review. (a) General rule. To the extent authorized by sections 1876(c...

  2. 42 CFR 411.46 - Lump-sum payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Lump-sum payments. 411.46 Section 411.46 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... Covered Under Workers' Compensation § 411.46 Lump-sum payments. (a) Lump-sum commutation of future...

  3. 42 CFR 423.2340 - Compliance monitoring and civil money penalties.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Compliance monitoring and civil money penalties. 423.2340 Section 423.2340 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... BENEFIT Medicare Coverage Gap Discount Program § 423.2340 Compliance monitoring and civil money penalties...

  4. 42 CFR 414.707 - Basis of payment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Basis of payment. 414.707 Section 414.707 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals...

  5. 42 CFR 414.707 - Basis of payment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Basis of payment. 414.707 Section 414.707 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals...

  6. 42 CFR 413.134 - Depreciation: Allowance for depreciation based on asset costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Depreciation: Allowance for depreciation based on asset costs. 413.134 Section 413.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT...

  7. 42 CFR 413.134 - Depreciation: Allowance for depreciation based on asset costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Depreciation: Allowance for depreciation based on asset costs. 413.134 Section 413.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT...

  8. 42 CFR 413.134 - Depreciation: Allowance for depreciation based on asset costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Depreciation: Allowance for depreciation based on asset costs. 413.134 Section 413.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT...

  9. 42 CFR 413.134 - Depreciation: Allowance for depreciation based on asset costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Depreciation: Allowance for depreciation based on asset costs. 413.134 Section 413.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT...

  10. 42 CFR 413.134 - Depreciation: Allowance for depreciation based on asset costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Depreciation: Allowance for depreciation based on asset costs. 413.134 Section 413.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT...

  11. 42 CFR 423.780 - Premium subsidy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost-Sharing Subsidies for Low... 42 Public Health 3 2010-10-01 2010-10-01 false Premium subsidy. 423.780 Section 423.780 Public...-service plans or 1876 cost plans) in a PDP region in the reference month. (ii) Premium amounts. The...

  12. 42 CFR 413.125 - Payment for home health agency services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for home health agency services. 413.125 Section 413.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  13. 42 CFR 414.108 - IOLs inserted in a physician's office.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false IOLs inserted in a physician's office. 414.108 Section 414.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee...

  14. 42 CFR 414.104 - PEN Items and Services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

  15. 42 CFR 405.2446 - Scope of services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Scope of services. 405.2446 Section 405.2446 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified Health...

  16. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false What constitutes a visit. 405.2463 Section 405.2463 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  17. 42 CFR 414.104 - PEN Items and Services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

  18. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false What constitutes a visit. 405.2463 Section 405.2463 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  19. 42 CFR 414.104 - PEN Items and Services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for...

  20. 42 CFR 414.104 - PEN Items and Services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

  1. 42 CFR 405.2446 - Scope of services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Scope of services. 405.2446 Section 405.2446 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified Health...

  2. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false What constitutes a visit. 405.2463 Section 405.2463 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  3. 42 CFR 414.104 - PEN Items and Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for...

  4. 42 CFR 405.2446 - Scope of services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Scope of services. 405.2446 Section 405.2446 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified Health...

  5. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false What constitutes a visit. 405.2463 Section 405.2463 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

  6. 42 CFR 405.440 - Emergency and urgent care services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Emergency and urgent care services. 405.440 Section 405.440 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.440...

  7. 42 CFR 405.2440 - Conditions for reinstatement after termination by CMS.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Conditions for reinstatement after termination by CMS. 405.2440 Section 405.2440 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural...

  8. 42 CFR 405.2446 - Scope of services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Scope of services. 405.2446 Section 405.2446 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified Health...

  9. 42 CFR 405.405 - General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false General rules. 405.405 Section 405.405 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.405 General rules. (a) A...

  10. 42 CFR 405.2434 - Content and terms of the agreement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Content and terms of the agreement. 405.2434 Section 405.2434 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and...

  11. 42 CFR 405.415 - Requirements of the private contract.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements of the private contract. 405.415 Section 405.415 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.415...

  12. 42 CFR 405.2450 - Clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Clinical psychologist and clinical social worker services. 405.2450 Section 405.2450 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural...

  13. 42 CFR 405.2410 - Application of Part B deductible and coinsurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Application of Part B deductible and coinsurance. 405.2410 Section 405.2410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health...

  14. 42 CFR 418.54 - Condition of participation: Initial and comprehensive assessment of the patient.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Condition of participation: Initial and comprehensive assessment of the patient. 418.54 Section 418.54 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE...

  15. 42 CFR 418.54 - Condition of participation: Initial and comprehensive assessment of the patient.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Condition of participation: Initial and comprehensive assessment of the patient. 418.54 Section 418.54 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE...

  16. 42 CFR 418.54 - Condition of participation: Initial and comprehensive assessment of the patient.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Condition of participation: Initial and comprehensive assessment of the patient. 418.54 Section 418.54 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE...

  17. 42 CFR 405.355 - Waiver of adjustment or recovery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Waiver of adjustment or recovery. 405.355 Section 405.355 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  18. 42 CFR 405.352 - Adjustment of title XVIII incorrect payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Adjustment of title XVIII incorrect payments. 405.352 Section 405.352 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  19. 42 CFR 405.357 - Notice of right to waiver consideration.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Notice of right to waiver consideration. 405.357 Section 405.357 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  20. 42 CFR 405.2100-405.2101 - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false [Reserved] 405.2100-405.2101 Section 405.2100-405.2101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of...

  1. 42 CFR 405.2131-405.2184 - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false [Reserved] 405.2131-405.2184 Section 405.2131-405.2184 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of...

  2. 42 CFR 405.359 - Liability of certifying or disbursing officer.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Liability of certifying or disbursing officer. 405.359 Section 405.359 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  3. 42 CFR 405.359 - Liability of certifying or disbursing officer.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Liability of certifying or disbursing officer. 405.359 Section 405.359 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  4. 42 CFR 405.2113 - Medical review board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Medical review board. 405.2113 Section 405.2113 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End...

  5. 42 CFR 405.355 - Waiver of adjustment or recovery.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Waiver of adjustment or recovery. 405.355 Section 405.355 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  6. 42 CFR 405.2113 - Medical review board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical review board. 405.2113 Section 405.2113 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End...

  7. 42 CFR 405.372 - Proceeding for suspension of payment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Proceeding for suspension of payment. 405.372 Section 405.372 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  8. 42 CFR 405.352 - Adjustment of title XVIII incorrect payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Adjustment of title XVIII incorrect payments. 405.352 Section 405.352 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  9. 42 CFR 405.373 - Proceeding for offset or recoupment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Proceeding for offset or recoupment. 405.373 Section 405.373 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  10. 42 CFR 405.2100-405.2101 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false [Reserved] 405.2100-405.2101 Section 405.2100-405.2101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of...

  11. 42 CFR 405.2131-405.2184 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false [Reserved] 405.2131-405.2184 Section 405.2131-405.2184 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of...

  12. 42 CFR 405.373 - Proceeding for offset or recoupment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Proceeding for offset or recoupment. 405.373 Section 405.373 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  13. 42 CFR 405.372 - Proceeding for suspension of payment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Proceeding for suspension of payment. 405.372 Section 405.372 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  14. 42 CFR 405.357 - Notice of right to waiver consideration.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Notice of right to waiver consideration. 405.357 Section 405.357 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

  15. 42 CFR 412.612 - Coordination of the collection of patient assessment data.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Coordination of the collection of patient assessment data. 412.612 Section 412.612 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL...

  16. 42 CFR 415.174 - Exception: Evaluation and management services furnished in certain centers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Exception: Evaluation and management services furnished in certain centers. 415.174 Section 415.174 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM SERVICES FURNISHED BY PHYSICIANS IN...

  17. 42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Physician fee schedule payment for services of teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM SERVICES FURNISHED BY PHYSICIANS IN...

  18. 42 CFR 489.1 - Statutory basis.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Statutory basis. 489.1 Section 489.1 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... regulations for the administration of the Medicare program. (b) Although section 1866 of the Act speaks only...

  19. 42 CFR 489.1 - Statutory basis.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Statutory basis. 489.1 Section 489.1 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... regulations for the administration of the Medicare program. (b) Although section 1866 of the Act speaks only...

  20. 42 CFR 489.1 - Statutory basis.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Statutory basis. 489.1 Section 489.1 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... regulations for the administration of the Medicare program. (b) Although section 1866 of the Act speaks only...

  1. 42 CFR 403.813 - Marketing limitations and record retention requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Marketing limitations and record retention requirements. 403.813 Section 403.813 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Medicare Prescription Drug Discount Card and Transitional Assistance...

  2. 42 CFR 405.2400 - Basis.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Basis. 405.2400 Section 405.2400 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL... Services § 405.2400 Basis. Subpart X is based on the provisions of the following sections of the Act...

  3. 42 CFR 406.2 - Scope.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., home health services, and hospice care. [48 FR 56026, Dec. 16, 1983, as amended at 50 FR 33033, Aug. 16... 42 Public Health 2 2010-10-01 2010-10-01 false Scope. 406.2 Section 406.2 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL...

  4. 42 CFR 418.100 - Condition of Participation: Organization and administration of services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Condition of Participation: Organization and administration of services. 418.100 Section 418.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  5. 42 CFR 418.100 - Condition of Participation: Organization and administration of services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Condition of Participation: Organization and administration of services. 418.100 Section 418.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  6. 42 CFR 418.100 - Condition of Participation: Organization and administration of services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Condition of Participation: Organization and administration of services. 418.100 Section 418.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  7. 42 CFR 410.22 - Limitations on services of an optometrist.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Limitations on services of an optometrist. 410.22 Section 410.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services...

  8. 42 CFR 410.172 - Payment for partial hospitalization services in CMHCs: Conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for partial hospitalization services in CMHCs: Conditions. 410.172 Section 410.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS...

  9. 42 CFR 410.25 - Limitations on services of a podiatrist.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Limitations on services of a podiatrist. 410.25 Section 410.25 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services...

  10. 42 CFR 409.64 - Services that are counted toward allowable amounts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Services that are counted toward allowable amounts. 409.64 Section 409.64 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409...

  11. 42 CFR 409.40 - Basis, purpose, and scope.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Basis, purpose, and scope. 409.40 Section 409.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.40 Basis, purpose...

  12. 42 CFR 410.160 - Part B annual deductible.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Part B annual deductible. 410.160 Section 410.160 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Payment of SMI Benefits § 410.160 Part B annual...

  13. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical and other health services: Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS...

  14. 42 CFR 409.47 - Place of service requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Place of service requirements. 409.47 Section 409.47 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.47 Place...

  15. 42 CFR 409.43 - Plan of care requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Plan of care requirements. 409.43 Section 409.43 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.43 Plan of care...

  16. 42 CFR 409.61 - General limitations on amount of benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false General limitations on amount of benefits. 409.61 Section 409.61 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.61 General...

  17. 42 CFR 409.62 - Lifetime maximum on inpatient psychiatric care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Lifetime maximum on inpatient psychiatric care. 409.62 Section 409.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409...

  18. 42 CFR 410.3 - Scope of benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... community mental health centers (CMHCs). (3) Other medicial services, equipment, and supplies that are not... 42 Public Health 2 2010-10-01 2010-10-01 false Scope of benefits. 410.3 Section 410.3 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM...

  19. 42 CFR 414.90 - Physician Quality Reporting System.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Physician Quality Reporting System. 414.90 Section 414.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Physicians and Other...

  20. 42 CFR 489.1 - Statutory basis.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Statutory basis. 489.1 Section 489.1 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... regulations for the administration of the Medicare program. (b) Although section 1866 of the Act speaks only...

  1. 42 CFR 489.1 - Statutory basis.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Statutory basis. 489.1 Section 489.1 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... regulations for the administration of the Medicare program. (b) Although section 1866 of the Act speaks only...

  2. 42 CFR 417.412 - Qualifying condition: Administration and management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Qualifying condition: Administration and management. 417.412 Section 417.412 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS...

  3. 42 CFR 411.384 - Disclosing advisory opinions and supporting information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT... Department of Justice, or any other Department or agency of the United States in connection with an advisory..., and will not be made publicly available. (d) Documents submitted by the requestor to CMS in connection...

  4. 42 CFR 417.531 - Hospice care services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospice care services. 417.531 Section 417.531... (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.531 Hospice care services. (a) If a Medicare enrollee of...

  5. 42 CFR 460.180 - Medicare payment to PACE organizations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medicare payment to PACE organizations. 460.180... FOR THE ELDERLY (PACE) Payment § 460.180 Medicare payment to PACE organizations. (a) Principle of payment. Under a PACE program agreement, CMS makes a prospective monthly payment to the PACE organization...

  6. 42 CFR 424.102 - Situations that do not constitute an emergency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... themselves indicate a need for emergency services: (a) Lack of care at home. (b) Lack of transportation to a....102 Section 424.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Special Conditions...

  7. Reducing the Deficit: Spending and Revenue Options

    DTIC Science & Technology

    2011-03-01

    the Conservation Reserve Program 25AgricultureOption 6 Reduce the Premium Subsidy in the Crop Insurance Program 26Option 7 Reduce by 20 Percentage...Graduate Students 31Option 11 Change the Interest Rate Structure for Student Loans 32HealthOption 12 Add a “Public Plan” to the Health Insurance Exchanges...Health Episodes Covered by Medicare 48Option 21 Reduce Medicare Costs by Changing the Cost-Sharing Structures for Medicare and Medigap Insurance 49Option

  8. 42 CFR 422.132 - Protection against liability and loss of benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422.132 Protection against liability and loss of benefits. Enrollees of MA organizations are... 42 Public Health 3 2010-10-01 2010-10-01 false Protection against liability and loss of benefits...

  9. 42 CFR 420.303 - HHS criteria for requesting books, documents, and records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false HHS criteria for requesting books, documents, and... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROGRAM INTEGRITY: MEDICARE Access to Books, Documents, and Records of Subcontractors § 420.303 HHS criteria for requesting books, documents, and records...

  10. 42 CFR 421.200 - Carrier functions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Carrier functions. 421.200 Section 421.200 Public...) MEDICARE PROGRAM MEDICARE CONTRACTING Carriers § 421.200 Carrier functions. A contract between CMS and a carrier specifies the functions to be performed by the carrier. The contract may include any or all of the...

  11. 42 CFR 412.521 - Basis of payment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Basis of payment. 412.521 Section 412.521 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... medical records requested by a QIO, in accordance with § 476.78(c) of this chapter. (c) Payment by workers...

  12. 42 CFR 406.32 - Monthly premiums.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Monthly premiums. 406.32 Section 406.32 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... at least the previous one year period to a worker who has 30 or more QCs; (3) Had been married to a...

  13. 42 CFR 417.500 - Intermediate sanctions for and civil monetary penalties against HMOs and CMPs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Intermediate sanctions for and civil monetary penalties against HMOs and CMPs. 417.500 Section 417.500 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE...

  14. 42 CFR 423.1074 - Right to request Departmental Appeals Board review of Administrative Law Judge's decision or...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Right to request Departmental Appeals Board review of Administrative Law Judge's decision or dismissal. 423.1074 Section 423.1074 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM...

  15. 42 CFR 423.1074 - Right to request Departmental Appeals Board review of Administrative Law Judge's decision or...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Right to request Departmental Appeals Board review of Administrative Law Judge's decision or dismissal. 423.1074 Section 423.1074 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM...

  16. 42 CFR 417.500 - Intermediate sanctions for and civil monetary penalties against HMOs and CMPs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Intermediate sanctions for and civil monetary penalties against HMOs and CMPs. 417.500 Section 417.500 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH...

  17. 42 CFR 417.500 - Intermediate sanctions for and civil monetary penalties against HMOs and CMPs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Intermediate sanctions for and civil monetary penalties against HMOs and CMPs. 417.500 Section 417.500 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH...

  18. 42 CFR 417.500 - Intermediate sanctions for and civil monetary penalties against HMOs and CMPs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Intermediate sanctions for and civil monetary penalties against HMOs and CMPs. 417.500 Section 417.500 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH...

  19. 42 CFR 417.500 - Intermediate sanctions for and civil monetary penalties against HMOs and CMPs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Intermediate sanctions for and civil monetary penalties against HMOs and CMPs. 417.500 Section 417.500 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE...

  20. 42 CFR 423.1074 - Right to request Departmental Appeals Board review of Administrative Law Judge's decision or...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Right to request Departmental Appeals Board review of Administrative Law Judge's decision or dismissal. 423.1074 Section 423.1074 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM...

  1. 42 CFR 410.15 - Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and limitations on coverage. 410.15 Section 410.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM...

  2. 42 CFR 405.435 - Failure to maintain opt-out.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Failure to maintain opt-out. 405.435 Section 405.435 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.435 Failure to...

  3. 42 CFR 405.420 - Requirements of the opt-out affidavit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements of the opt-out affidavit. 405.420 Section 405.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.420...

  4. 42 CFR 405.445 - Renewal and early termination of opt-out.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Renewal and early termination of opt-out. 405.445 Section 405.445 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.445...

  5. 42 CFR 405.2403 - Content and terms of the agreement with the Secretary.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Content and terms of the agreement with the Secretary. 405.2403 Section 405.2403 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural...

  6. 42 CFR 405.2413 - Services and supplies incident to a physician's services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Services and supplies incident to a physician's services. 405.2413 Section 405.2413 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural...

  7. 42 CFR 405.430 - Failure to properly opt-out.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Failure to properly opt-out. 405.430 Section 405.430 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.430 Failure to...

  8. 42 CFR 405.2452 - Services and supplies incident to clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Services and supplies incident to clinical psychologist and clinical social worker services. 405.2452 Section 405.2452 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR...

  9. 42 CFR 405.354 - Procedures for adjustment or recovery-title II beneficiary.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Procedures for adjustment or recovery-title II beneficiary. 405.354 Section 405.354 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  10. 42 CFR 405.354 - Procedures for adjustment or recovery-title II beneficiary.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Procedures for adjustment or recovery-title II beneficiary. 405.354 Section 405.354 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  11. 42 CFR 405.356 - Principles applied in waiver of adjustment or recovery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Principles applied in waiver of adjustment or recovery. 405.356 Section 405.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  12. 42 CFR 405.375 - Time limits for, and notification of, administrative determination after receipt of rebuttal...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Time limits for, and notification of, administrative determination after receipt of rebuttal statement. 405.375 Section 405.375 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL...

  13. 42 CFR 405.375 - Time limits for, and notification of, administrative determination after receipt of rebuttal...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Time limits for, and notification of, administrative determination after receipt of rebuttal statement. 405.375 Section 405.375 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL...

  14. 42 CFR 405.351 - Incorrect payments for which the individual is not liable.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Incorrect payments for which the individual is not liable. 405.351 Section 405.351 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  15. 42 CFR 405.358 - When waiver of adjustment or recovery may be applied.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false When waiver of adjustment or recovery may be applied. 405.358 Section 405.358 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  16. 42 CFR 405.356 - Principles applied in waiver of adjustment or recovery.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Principles applied in waiver of adjustment or recovery. 405.356 Section 405.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  17. 42 CFR 405.351 - Incorrect payments for which the individual is not liable.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Incorrect payments for which the individual is not liable. 405.351 Section 405.351 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  18. 42 CFR 405.358 - When waiver of adjustment or recovery may be applied.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false When waiver of adjustment or recovery may be applied. 405.358 Section 405.358 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...

  19. 42 CFR 414.58 - Payment of charges for physician services to patients in providers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment of charges for physician services to patients in providers. 414.58 Section 414.58 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER...

  20. 77 FR 34050 - Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel-June 25, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-08

    ... productivity adjustment. This meeting is open to the public in accordance with the Federal Advisory Committee...). The review will include the inputs, input weights, price-measurement proxies, and productivity... the index's productivity adjustment. II. Meeting Format This meeting is open to the public. There will...

  1. 42 CFR 409.66 - Revocation of election not to use lifetime reserve days.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Revocation of election not to use lifetime reserve days. 409.66 Section 409.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance...

  2. 42 CFR 423.440 - Prohibition of State imposition of premium taxes; relation to State laws.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...; relation to State laws. 423.440 Section 423.440 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Organization Compliance with State Law and Preemption by Federal Law § 423.440 Prohibition of...

  3. 42 CFR 417.558 - Emergency, urgently needed, and out-of-area services for which the HMO or CMP accepts...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services for which the HMO or CMP accepts responsibility. 417.558 Section 417.558 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost...

  4. Medicare and Medicaid Physician Payment Incentives

    PubMed Central

    Burney, Ira L.; Schieber, George J.; Blaxall, Martha O.; Gabel, Jon R.

    1979-01-01

    The incentives in the Medicare and Medicaid physician payment systems and their effects on six interrelated aspects of health care costs and beneficiary access to care were analyzed. Research results and data presented indicate that Medicare and Medicaid physician payment incentives are inconsistent with current public policy goals of (1) containing inflation in fees and expenditures, (2) encouraging physician participation in public programs, (3) improving the geographic and specialty distributions of physicians, (4) encouraging primary care instead of surgery, and also outpatient rather than inpatient treatment. PMID:10309053

  5. Medicare and state health care programs: fraud and abuse, civil money penalties and intermediate sanctions for certain violations by health maintenance organizations and competitive medical plans--HHS. Final rule.

    PubMed

    1994-07-15

    This final rule implements sections 9312(c)(2), 9312(f), and 9434(b) of Public Law 99-509, section 7 of Public Law 100-93, section 4014 of Public Law 100-203, sections 224 and 411(k)(12) of Public Law 100-360, and section 6411(d)(3) of Public Law 101-239. These provisions broaden the Secretary's authority to impose intermediate sanctions and civil money penalties on health maintenance organizations (HMOs), competitive medical plans, and other prepaid health plans contracting under Medicare or Medicaid that (1) substantially fail to provide an enrolled individual with required medically necessary items and services; (2) engage in certain marketing, enrollment, reporting, or claims payment abuses; or (3) in the case of Medicare risk-contracting plans, employ or contract with, either directly or indirectly, an individual or entity excluded from participation in Medicare. The provisions also condition Federal financial participation in certain State payments on the State's exclusion of certain prohibited entities from participation in HMO contracts and waiver programs. This final rule is intended to significantly enhance the protections for Medicare beneficiaries and Medicaid recipients enrolled in a HMO, competitive medical plan, or other contracting organization under titles XVIII and XIX of the Social Security Act.

  6. 42 CFR 424.516 - Additional provider and supplier requirements for enrolling and maintaining active enrollment...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... enrolling and maintaining active enrollment status in the Medicare program. 424.516 Section 424.516 Public... active enrollment status in the Medicare program. (a) Certifying compliance. CMS enrolls and maintains an active enrollment status for a provider or supplier when that provider or supplier certifies that it...

  7. 42 CFR 424.516 - Additional provider and supplier requirements for enrolling and maintaining active enrollment...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... enrolling and maintaining active enrollment status in the Medicare program. 424.516 Section 424.516 Public... active enrollment status in the Medicare program. (a) Certifying compliance. CMS enrolls and maintains an active enrollment status for a provider or supplier when that provider or supplier certifies that it...

  8. 42 CFR 424.516 - Additional provider and supplier requirements for enrolling and maintaining active enrollment...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... enrolling and maintaining active enrollment status in the Medicare program. 424.516 Section 424.516 Public... maintaining active enrollment status in the Medicare program. (a) Certifying compliance. CMS enrolls and maintains an active enrollment status for a provider or supplier when that provider or supplier certifies...

  9. 42 CFR 422.455 - Special rules for MA Regional Plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for MA Regional Plans. 422.455... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Special Rules for MA Regional Plans § 422.455 Special rules for MA Regional Plans. (a) Coverage of entire MA region. The service area for an MA...

  10. 42 CFR 422.455 - Special rules for MA Regional Plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Special rules for MA Regional Plans. 422.455... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Special Rules for MA Regional Plans § 422.455 Special rules for MA Regional Plans. (a) Coverage of entire MA region. The service area...

  11. 42 CFR 422.455 - Special rules for MA Regional Plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Special rules for MA Regional Plans. 422.455... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Special Rules for MA Regional Plans § 422.455 Special rules for MA Regional Plans. (a) Coverage of entire MA region. The service area for an MA...

  12. 42 CFR 422.455 - Special rules for MA Regional Plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Special rules for MA Regional Plans. 422.455... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Special Rules for MA Regional Plans § 422.455 Special rules for MA Regional Plans. (a) Coverage of entire MA region. The service area...

  13. 42 CFR 422.455 - Special rules for MA Regional Plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Special rules for MA Regional Plans. 422.455... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Special Rules for MA Regional Plans § 422.455 Special rules for MA Regional Plans. (a) Coverage of entire MA region. The service area...

  14. 78 FR 4413 - Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... Medicare Advantage and Prescription Drug Program: Part C Explanation of Benefits CFR 422.111(b)(12)'' that... period for the document entitled ``The Medicare Advantage and Prescription Drug Program: Part C Explanation of Benefits CFR 422.111(b)(12).'' There were technical delays with making the information...

  15. Secret weapon: the "new" Medicare as a route to health security.

    PubMed

    Schlesinger, Mark; Hacker, Jacob S

    2007-04-01

    Over the past twenty years, Medicare has been transformed from a single-payer insurer into a hybrid of complementary public and private insurance arrangements. Despite creating ongoing controversy, these changes have resulted in an ironic and largely overlooked strategic potential: Medicare's evolving hybrid form makes it the most promising vehicle for overcoming the historical obstacles to universal health insurance in the United States. To make this surprising case, we first explore the distinctive political dynamics of programs that, like today's Medicare, are hybrids of public and private arrangements. We then consider how these political dynamics might circumvent past barriers to universal health insurance. Finally, we discuss the strengths and weaknesses of alternative pathways through which Medicare could be expanded to promote health security.

  16. 42 CFR 405.376 - Suspension and termination of collection action and compromise of claims for overpayment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Suspension and termination of collection action and compromise of claims for overpayment. 405.376 Section 405.376 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED...

  17. 42 CFR 405.353 - Certification of amount that will be adjusted against individual title II or railroad retirement...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Certification of amount that will be adjusted against individual title II or railroad retirement benefits. 405.353 Section 405.353 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL...

  18. 42 CFR 405.376 - Suspension and termination of collection action and compromise of claims for overpayment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Suspension and termination of collection action and compromise of claims for overpayment. 405.376 Section 405.376 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED...

  19. 42 CFR 405.353 - Certification of amount that will be adjusted against individual title II or railroad retirement...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Certification of amount that will be adjusted against individual title II or railroad retirement benefits. 405.353 Section 405.353 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL...

  20. 42 CFR 412.102 - Special treatment: Hospitals located in areas that are reclassified from urban to rural as a...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Hospitals located in areas that...

  1. 42 CFR 412.62 - Federal rates for inpatient operating costs for fiscal year 1984.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Federal rates for inpatient operating costs for fiscal year 1984. 412.62 Section 412.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Basic Methodology for Determining...

  2. 42 CFR 412.62 - Federal rates for inpatient operating costs for fiscal year 1984.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Federal rates for inpatient operating costs for fiscal year 1984. 412.62 Section 412.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Basic Methodology for Determining...

  3. 42 CFR 412.62 - Federal rates for inpatient operating costs for fiscal year 1984.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Federal rates for inpatient operating costs for fiscal year 1984. 412.62 Section 412.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Basic Methodology for Determining...

  4. 42 CFR 409.50 - Coinsurance for durable medical equipment (DME) furnished as a home health service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Coinsurance for durable medical equipment (DME) furnished as a home health service. 409.50 Section 409.50 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health...

  5. 42 CFR 409.63 - Reduction of inpatient psychiatric benefit days available in the initial benefit period.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Reduction of inpatient psychiatric benefit days available in the initial benefit period. 409.63 Section 409.63 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of...

  6. 42 CFR 405.1028 - Prehearing case review of evidence submitted to the ALJ.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Prehearing case review of evidence submitted to the ALJ. 405.1028 Section 405.1028 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Determinations, Redeterminations, Reconsiderations,...

  7. 42 CFR 441.106 - Comprehensive mental health program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Comprehensive mental health program. 441.106 Section 441.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Comprehensive mental health program. (a) If the plan includes services in public institutions for mental...

  8. 42 CFR 441.106 - Comprehensive mental health program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Comprehensive mental health program. 441.106 Section 441.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Comprehensive mental health program. (a) If the plan includes services in public institutions for mental...

  9. 42 CFR 441.106 - Comprehensive mental health program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Comprehensive mental health program. 441.106 Section 441.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Comprehensive mental health program. (a) If the plan includes services in public institutions for mental...

  10. 42 CFR 441.106 - Comprehensive mental health program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Comprehensive mental health program. 441.106 Section 441.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Comprehensive mental health program. (a) If the plan includes services in public institutions for mental...

  11. 42 CFR 441.106 - Comprehensive mental health program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Comprehensive mental health program. 441.106 Section 441.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Comprehensive mental health program. (a) If the plan includes services in public institutions for mental...

  12. 76 FR 53477 - Medicare Program; Meeting of the Medicare Evidence Development and Coverage Advisory Committee...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... macular edema (DME). This meeting is open to the public in accordance with the Federal Advisory Committee... regarding antivascular endothelial growth factor (anti-VEGF) treatment of diabetic macular edema (DME...

  13. 78 FR 38594 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-27

    ..., and in view of the slight differences between these rules, we requested public comment on whether the...: This final rule will revise the requirements that an institution will have to meet in order to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility...

  14. Medicare part D data: major changes on the horizon.

    PubMed

    Greenwald, Leslie M

    2007-10-01

    The 3 primary administrative data sets developed by the Centers for Medicare and Medicaid services (CMS) to support the Medicare Part D program implementation represent a valuable source of data for health services researchers. This paper describes the structure of the Medicare Part D program and the related databases, and discusses their utilization for research purposes. The Medicare Part D administrative data include information on plan benefits (integrated into the Health Plan Management System), beneficiary enrollment files, and prescription drug event (PDE) claims-type data. The enrollment data may be of use in investigating the benefits and plan types that appeal to beneficiaries, but their application is limited by the fact that, although individual beneficiaries' enrollment choices are recorded, only summary enrollment data are currently publicly available. PDE data are likely to be of most interest to researchers as they are detailed (including beneficiary identifiers, contract identifiers pharmacy provider information on drugs provided, drug cost, and insurance status), beneficiary-specific (allowing them to be linked to beneficiary characteristics), and an unusual output for a program reimbursed under a capitation-based system. Because PDE data are highly sensitive, only summary data on the number of Part D prescriptions filled are publicly available. Although the data collected in relation to the Medicare Part D program could be applied to many questions of interest to health services researchers, their utility is limited by the sensitive natures of many of these data, making it difficult currently to obtain access for research purposes.

  15. Medicare Financial Status, Budget Impact, and Sustainability—Which Concept is Which?

    PubMed Central

    Foster, Richard S.; Clemens, M. Kent

    2005-01-01

    Medicare is continually undergoing change, as it must in order to reflect advances in medical technology, new health care delivery systems, financial pressures, and other developments. Modifications to the program are debated by policymakers in Congress and the administration, together with academic experts and others. These debates would be improved if policymakers and the public had a clearer understanding of Medicare and certain commonly cited views of the program's overall status. Three such concepts—the financial status of the Medicare trust funds, the impact of Medicare on the Federal budget, and the long-run sustainability of Medicare—are often confused with each other and are sometimes used interchangeably. Each concept is important but needs to be used for its own purpose. This article clarifies the differences among these three views of Medicare and provides examples of each. PMID:17290643

  16. Medicare Financial Status, Budget Impact, and Sustainability—Which Concept is Which?

    PubMed Central

    Foster, Richard S.; Clemens, M. Kent

    2009-01-01

    Medicare is continually undergoing change, as it must in order to reflect advances in medical technology, new health care delivery systems, financial pressures, and other developments. Modifications to the program are debated by policymakers in Congress and the administration, together with academic experts and others. These debates would be improved if policymakers and the public had a clearer understanding of Medicare and certain commonly cited views of the program's overall status. Three such concepts—the financial status of the Medicare trust funds, the impact of Medicare on the Federal budget, and the long-run sustainability of Medicare—are often confused with each other and are sometimes used interchangeably. Each concept is important but needs to be used for its own purpose. This article clarifies the differences among these three views of Medicare and provides examples of each. PMID:19544937

  17. 42 CFR 455.232 - Medicaid integrity audit program contractor functions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

  18. 42 CFR 455.232 - Medicaid integrity audit program contractor functions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

  19. 42 CFR 455.232 - Medicaid integrity audit program contractor functions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

  20. 42 CFR 455.232 - Medicaid integrity audit program contractor functions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

  1. 42 CFR 423.566 - Coverage determinations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Coverage determinations. 423.566 Section 423.566... (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Grievances, Coverage Determinations, Redeterminations, and Reconsiderations § 423.566 Coverage determinations. (a) Responsibilities of...

  2. 76 FR 44011 - Medicare Program; Meeting of the Medicare Evidence Development and Coverage Advisory Committee...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ...-VEGF) treatment of diabetic macular edema (DME). This meeting is open to the public in accordance with... macular edema (DME). Background information about this topic, including panel materials, is available at...

  3. 42 CFR 414.806 - Penalties associated with the failure to submit timely and accurate ASP data.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Penalties associated with the failure to submit timely and accurate ASP data. 414.806 Section 414.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES...

  4. 42 CFR 414.806 - Penalties associated with the failure to submit timely and accurate ASP data.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Penalties associated with the failure to submit timely and accurate ASP data. 414.806 Section 414.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES...

  5. 42 CFR 414.806 - Penalties associated with the failure to submit timely and accurate ASP data.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Penalties associated with the failure to submit timely and accurate ASP data. 414.806 Section 414.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Submission of...

  6. 42 CFR 414.806 - Penalties associated with the failure to submit timely and accurate ASP data.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Penalties associated with the failure to submit timely and accurate ASP data. 414.806 Section 414.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Submission of...

  7. 42 CFR 414.806 - Penalties associated with the failure to submit timely and accurate ASP data.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Penalties associated with the failure to submit timely and accurate ASP data. 414.806 Section 414.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES...

  8. 77 FR 70447 - Medicare Program; Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment (HOP...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... meeting in person must register online, during the above specified timeframe at: https://www.cms.gov/apps... agenda items. All presentations will be considered public information and may be posted on the CMS Web site and will be shared with the public. Presenters should not send pictures of patients or Medicare...

  9. Medicare covers the majority of FDA-approved devices and Part B drugs, but restrictions and discrepancies remain.

    PubMed

    Chambers, James D; May, Katherine E; Neumann, Peter J

    2013-06-01

    The Food and Drug Administration (FDA) and Medicare use different standards to determine, first, whether a new drug or medical device can be marketed to the public and, second, if the federal health insurance program will pay for use of the drug or device. This discrepancy creates hurdles and uncertainty for drug and device manufacturers. We analyzed discrepancies between FDA approval and Medicare national coverage determinations for sixty-nine devices and Part B drugs approved during 1999-2011. We found that Medicare covered FDA-approved drugs or devices 80 percent of the time. However, Medicare often added conditions beyond FDA approval, particularly for devices and most often restricting coverage to patients with the most severe disease. In some instances, Medicare was less restrictive than the FDA. Our findings highlight the importance for drug and device makers of anticipating Medicare's needs when conducting clinical studies to support their products. Our findings also provide important insights for the FDA's and Medicare's pilot parallel review program.

  10. 77 FR 38067 - Medicare Program; Public Meeting Regarding Inherent Reasonableness of Medicare Fee Schedule...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-26

    ... forth in 42 CFR 414.402 will be used to determine what items will be included in the competitions. These..., regardless of the method of delivery. Non-Mail Order Item--Any item that a beneficiary or caregiver picks up... what Medicare pays for mail order supplies versus non-mail order supplies may encourage fraud and abuse...

  11. 42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b... coordination between a State child health program and other public health insurance programs. (b) Obligations...

  12. 42 CFR 413.235 - Patient-level adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

  13. 42 CFR 413.235 - Patient-level adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

  14. 42 CFR 413.235 - Patient-level adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

  15. 42 CFR 413.235 - Patient-level adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

  16. 42 CFR 421.120 - Performance criteria.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Performance criteria. 421.120 Section 421.120... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE CONTRACTING Intermediaries § 421.120 Performance criteria. (a) Application of performance criteria. As part of the intermediary evaluations authorized by...

  17. 42 CFR 421.120 - Performance criteria.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Performance criteria. 421.120 Section 421.120... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE CONTRACTING Intermediaries § 421.120 Performance criteria. (a) Application of performance criteria. As part of the intermediary evaluations authorized by...

  18. 42 CFR 421.120 - Performance criteria.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Performance criteria. 421.120 Section 421.120... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE CONTRACTING Intermediaries § 421.120 Performance criteria. (a) Application of performance criteria. As part of the intermediary evaluations authorized by...

  19. 42 CFR 455.230 - Eligibility requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Eligibility requirements. 455.230 Section 455.230 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid Integrity Program § 455.230...

  20. Public/private partnerships for prescription drug coverage: policy formulation and outcomes in Quebec's universal drug insurance program, with comparisons to the Medicare prescription drug program in the United States.

    PubMed

    Pomey, Marie-Pascale; Forest, Pierre-Gerlier; Palley, Howard A; Martin, Elisabeth

    2007-09-01

    In January 1997, the government of Quebec, Canada, implemented a public/private prescription drug program that covered the entire population of the province. Under this program, the public sector collaborates with private insurers to protect all Quebecers from the high cost of drugs. This article outlines the principal features and history of the Quebec plan and draws parallels between the factors that led to its emergence and those that led to the passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) in the United States. It also discusses the challenges and similarities of both programs and analyzes Quebec's ten years of experience to identify adjustments that may help U.S. policymakers optimize the MMA.

  1. Public/Private Partnerships for Prescription Drug Coverage: Policy Formulation and Outcomes in Quebec's Universal Drug Insurance Program, with Comparisons to the Medicare Prescription Drug Program in the United States

    PubMed Central

    Pomey, Marie-Pascale; Forest, Pierre-Gerlier; Palley, Howard A; Martin, Elisabeth

    2007-01-01

    In January 1997, the government of Quebec, Canada, implemented a public/private prescription drug program that covered the entire population of the province. Under this program, the public sector collaborates with private insurers to protect all Quebecers from the high cost of drugs. This article outlines the principal features and history of the Quebec plan and draws parallels between the factors that led to its emergence and those that led to the passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) in the United States. It also discusses the challenges and similarities of both programs and analyzes Quebec's ten years of experience to identify adjustments that may help U.S. policymakers optimize the MMA. PMID:17718665

  2. 42 CFR 412.73 - Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period. 412.73 Section 412.73 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Determinatio...

  3. 42 CFR 412.77 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. 412.77 Section 412.77 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

  4. 42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

  5. 42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

  6. 42 CFR 412.78 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. 412.78 Section 412.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

  7. 42 CFR 412.73 - Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period. 412.73 Section 412.73 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Determinatio...

  8. 42 CFR 412.73 - Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period. 412.73 Section 412.73 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Determinatio...

  9. 42 CFR 412.77 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. 412.77 Section 412.77 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

  10. 42 CFR 412.77 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. 412.77 Section 412.77 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

  11. 42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

  12. 42 CFR 412.77 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. 412.77 Section 412.77 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

  13. 42 CFR 412.78 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. 412.78 Section 412.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

  14. 42 CFR 412.78 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. 412.78 Section 412.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

  15. 42 CFR 412.73 - Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period. 412.73 Section 412.73 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Determinatio...

  16. 42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

  17. 42 CFR 412.78 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. 412.78 Section 412.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

  18. 42 CFR 421.122 - Performance standards.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Performance standards. 421.122 Section 421.122... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE CONTRACTING Intermediaries § 421.122 Performance standards. (a) Development of standards. In addition to the performance criteria (§ 421.120), CMS develops...

  19. 42 CFR 421.122 - Performance standards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Performance standards. 421.122 Section 421.122... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE CONTRACTING Intermediaries § 421.122 Performance standards. (a) Development of standards. In addition to the performance criteria (§ 421.120), CMS develops...

  20. 42 CFR 421.122 - Performance standards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Performance standards. 421.122 Section 421.122... (CONTINUED) MEDICARE PROGRAM MEDICARE CONTRACTING Intermediaries § 421.122 Performance standards. (a) Development of standards. In addition to the performance criteria (§ 421.120), CMS develops detailed...

  1. 42 CFR 421.122 - Performance standards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Performance standards. 421.122 Section 421.122... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE CONTRACTING Intermediaries § 421.122 Performance standards. (a) Development of standards. In addition to the performance criteria (§ 421.120), CMS develops...

  2. 42 CFR 417.408 - Contract application process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Contract application process. 417.408 Section 417... (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Qualifying Conditions for Medicare Contracts § 417.408 Contract application process. (a...

  3. 42 CFR 421.212 - Railroad Retirement Board contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Railroad Retirement Board contracts. 421.212... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE CONTRACTING Carriers § 421.212 Railroad Retirement Board contracts. In accordance with this subpart C, the Railroad Retirement Board contracts with DMEPOS regional...

  4. 42 CFR 421.100 - Intermediary functions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Intermediary functions. 421.100 Section 421.100... (CONTINUED) MEDICARE PROGRAM MEDICARE CONTRACTING Intermediaries § 421.100 Intermediary functions. An agreement between CMS and an intermediary specifies the functions to be performed by the intermediary. (a...

  5. 42 CFR 413.17 - Cost to related organizations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....17 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... related to the provider by common ownership or control are includable in the allowable cost of the...

  6. 42 CFR 413.17 - Cost to related organizations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....17 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... related to the provider by common ownership or control are includable in the allowable cost of the...

  7. 42 CFR 413.17 - Cost to related organizations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....17 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... related to the provider by common ownership or control are includable in the allowable cost of the...

  8. 42 CFR 421.120 - Performance criteria.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Performance criteria. 421.120 Section 421.120... (CONTINUED) MEDICARE PROGRAM MEDICARE CONTRACTING Intermediaries § 421.120 Performance criteria. (a) Application of performance criteria. As part of the intermediary evaluations authorized by section 1816(f) of...

  9. 42 CFR 421.120 - Performance criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Performance criteria. 421.120 Section 421.120... (CONTINUED) MEDICARE PROGRAM MEDICARE CONTRACTING Intermediaries § 421.120 Performance criteria. (a) Application of performance criteria. As part of the intermediary evaluations authorized by section 1816(f) of...

  10. 76 FR 71573 - Medicare Program; Request for Nominations for Members for the Medicare Evidence Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... individual qualifications and not as representatives of professional associations or societies. We wish to... subspecialties, administrative medicine, public health, biological and physical sciences, epidemiology and... as representatives of professional associations or societies. We wish to ensure adequate...

  11. 42 CFR 423.2276 - Employer group retiree marketing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Employer group retiree marketing. 423.2276 Section... SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Part D Marketing Requirements § 423.2276 Employer group retiree marketing. Part D sponsors may develop marketing materials...

  12. 42 CFR § 414.1395 - Public reporting.

    Code of Federal Regulations, 2010 CFR

    2017-10-01

    ... (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1395 Public reporting. (a) Public...

  13. 42 CFR 438.240 - Quality assessment and performance improvement program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

  14. 42 CFR 438.240 - Quality assessment and performance improvement program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

  15. 42 CFR 438.240 - Quality assessment and performance improvement program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

  16. 42 CFR 438.240 - Quality assessment and performance improvement program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

  17. 42 CFR 430.0 - Program description.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Program description. 430.0 Section 430.0 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 430.0 Program description. Title XIX of the Social Security Act, enacted in 1965, authorizes...

  18. 42 CFR 430.0 - Program description.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Program description. 430.0 Section 430.0 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 430.0 Program description. Title XIX of the Social Security Act, enacted in 1965, authorizes...

  19. 42 CFR 455.17 - Reporting requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Reporting requirements. 455.17 Section 455.17 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid Agency Fraud Detection and...

  20. 42 CFR 417.478 - Requirements of other laws and regulations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements of other laws and regulations. 417.478... SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Contract Requirements § 417.478 Requirements of other laws and...

  1. 42 CFR 417.520 - Effect on HMO and CMP contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 417.520 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND... these provisions, references to “M+C organizations” must be read as references to “HMOs and CMPs”. (c...

  2. 42 CFR 412.20 - Hospital services subject to the prospective payment systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... payment systems. 412.20 Section 412.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Hospital Services Subject to and Excluded From the Prospective Payment Systems for Inpatient...

  3. 42 CFR 409.5 - General description of benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false General description of benefits. 409.5 Section 409... MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Hospital Insurance Benefits: General Provisions § 409.5 General description of benefits. Hospital insurance (Part A of Medicare) helps pay for inpatient hospital...

  4. 78 FR 63986 - Medicare Program; Request for Nominations for Members for the Medicare Evidence Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... individual qualifications and not as representatives of professional associations or societies. We wish to..., administrative medicine, public health, biological and physical sciences, epidemiology and biostatistics... individual qualifications and not as representatives of professional associations or societies. We wish to...

  5. 42 CFR 423.2046 - Notice of an ALJ decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... making the determination; (2) The procedures for obtaining additional information concerning the decision... 42 Public Health 3 2010-10-01 2010-10-01 false Notice of an ALJ decision. 423.2046 Section 423... (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review...

  6. 42 CFR 456.719 - Funding for DUR program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Funding for DUR program. 456.719 Section 456.719 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Claims Management System for Outpatient Drug Claims § 456.719 Funding for DUR program. FFP is available...

  7. 42 CFR 456.719 - Funding for DUR program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Funding for DUR program. 456.719 Section 456.719 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Claims Management System for Outpatient Drug Claims § 456.719 Funding for DUR program. FFP is available...

  8. Additional reductions in Medicare spending growth will likely require shifting costs to beneficiaries.

    PubMed

    Chernew, Michael E

    2013-05-01

    Policy makers have considerable interest in reducing Medicare spending growth. Clarity in the debate on reducing Medicare spending growth requires recognition of three important distinctions: the difference between public and total spending on health, the difference between the level of health spending and rate of health spending growth, and the difference between growth per beneficiary and growth in the number of beneficiaries in Medicare. The primary policy issue facing the US health care system is the rate of spending growth in public programs, and solving that problem will probably require reforms to the entire health care sector. The Affordable Care Act created a projected trajectory for Medicare spending per beneficiary that is lower than historical growth rates. Although opportunities for one-time savings exist, any long-term savings from Medicare, beyond those already forecast, will probably require a shift in spending from taxpayers to beneficiaries via higher beneficiary premium contributions (overall or via means testing), changes in eligibility, or greater cost sharing at the point of service.

  9. Disease prevention policy under Medicare: a historical and political analysis.

    PubMed

    Schauffler, H H

    1993-01-01

    I review the history and politics of Medicare disease prevention policy and identify factors associated with the success or failure of legislative initiatives to add preventive services benefits to Medicare. Between 1965 and 1990, 453 bills for Medicare preventive services were introduced in the U.S. Congress, but not until 1980, after 350 bills had failed, was the first preventive service added to the Medicare program. Medicare currently pays for only four of the 44 preventive services recommended for the elderly by the U.S. Preventive Services Task Force (pneumococcal and hepatitis B vaccinations, Pap smears, and mammography). In addition, Congress has funded demonstration programs for the influenza vaccine and comprehensive preventive services. The preventive services added to Medicare reflect the bias of the biomedical model toward screening and immunizations. Counseling services have received the least legislative attention. Factors associated with successful enactment include single-benefit bills, incorporation into budget-deficit reduction legislation, documented evidence of cost-effectiveness, public hearings, sponsorship by chairs of key congressional committees, and persistent congressional leadership. Factors associated with failure include lack of support from Medicare beneficiaries, lack of professional support, impact on total Medicare expenditures, disagreement over or failure to address payment and financing mechanisms, and competing congressional priorities.

  10. 42 CFR 417.585 - Special rules: Hospice care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules: Hospice care. 417.585 Section 417... (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.585 Special rules: Hospice care. (a) No payment is made...

  11. 42 CFR 413.24 - Adequate cost data and cost finding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 413.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... provider to ascertain costs of the various types of services furnished. It is the determination of these...

  12. 42 CFR 413.24 - Adequate cost data and cost finding.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 413.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... provider to ascertain costs of the various types of services furnished. It is the determination of these...

  13. 42 CFR 423.886 - Retiree drug subsidy amounts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Retiree drug subsidy amounts. 423.886 Section 423... (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.886 Retiree drug subsidy amounts. (a) Amount of subsidy payment. (1...

  14. 42 CFR 423.886 - Retiree drug subsidy amounts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Retiree drug subsidy amounts. 423.886 Section 423... (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.886 Retiree drug subsidy amounts. (a) Amount of subsidy payment. (1...

  15. 42 CFR 423.886 - Retiree drug subsidy amounts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Retiree drug subsidy amounts. 423.886 Section 423... (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.886 Retiree drug subsidy amounts. (a) Amount of subsidy payment. (1...

  16. 42 CFR 419.20 - Hospitals subject to the hospital outpatient prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... prospective payment system. 419.20 Section 419.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL... Outpatient Prospective Payment System § 419.20 Hospitals subject to the hospital outpatient prospective...

  17. 42 CFR 412.6 - Cost reporting periods subject to the prospective payment systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... payment systems. 412.6 Section 412.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES... prospective payment system for inpatient operating costs, the reasonable costs of services furnished before...

  18. 77 FR 38837 - Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... weights, price-measurement proxies, and productivity adjustment. This meeting is open to the public in... productivity adjustment. For more information on the Panel, see the October 7, 2011 Federal Register (76 FR... recommendations regarding the MEI's inputs, input weights, price- measurement proxies, and the productivity...

  19. 42 CFR 416.40 - Condition for coverage-Compliance with State licensure law.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... licensure law. 416.40 Section 416.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM AMBULATORY SURGICAL SERVICES Specific Conditions for Coverage § 416.40 Condition for coverage—Compliance with State licensure law. The ASC must comply...

  20. 42 CFR 407.32 - Prejudice to enrollment rights because of Federal Government misrepresentation, inaction, or error.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Government misrepresentation, inaction, or error. 407.32 Section 407.32 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE... enrollment rights because of Federal Government misrepresentation, inaction, or error. If an individual's...

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