12 CFR 303.244 - Golden parachute and severance plan payments.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... Pursuant to section 18(k) of the FDI Act (12 U.S.C. 1828(k)) and part 359 of this chapter, an insured... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Golden parachute and severance plan payments... in excess of the 12-month amount specified in § 359.1(f)(2)(v). (b) Where to file. Applicants shall...

12 CFR 303.244 - Golden parachute and severance plan payments.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... Pursuant to section 18(k) of the FDI Act (12 U.S.C. 1828(k)) and part 359 of this chapter, an insured... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Golden parachute and severance plan payments... in excess of the 12-month amount specified in § 359.1(f)(2)(v). (b) Where to file. Applicants shall...

12 CFR 303.244 - Golden parachute and severance plan payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Pursuant to section 18(k) of the FDI Act (12 U.S.C. 1828(k)) and part 359 of this chapter, an insured... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Golden parachute and severance plan payments... in excess of the 12-month amount specified in § 359.1(f)(2)(v). (b) Where to file. Applicants shall...

12 CFR 303.244 - Golden parachute and severance plan payments.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... Pursuant to section 18(k) of the FDI Act (12 U.S.C. 1828(k)) and part 359 of this chapter, an insured... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Golden parachute and severance plan payments... in excess of the 12-month amount specified in § 359.1(f)(2)(v). (b) Where to file. Applicants shall...

12 CFR 303.244 - Golden parachute and severance plan payments.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... Pursuant to section 18(k) of the FDI Act (12 U.S.C. 1828(k)) and part 359 of this chapter, an insured... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Golden parachute and severance plan payments... in excess of the 12-month amount specified in § 359.1(f)(2)(v). (b) Where to file. Applicants shall...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

12 CFR Appendix F - Optional Annual Percentage Rate Computations for Creditors Offering Open-End Plans Subject to the...

Code of Federal Regulations, 2014 CFR

2014-01-01

...) TRUTH IN LENDING (REGULATION Z) Special Rules Applicable to Credit Card Accounts and Open-End Credit... balance (previous balance less payments and credits) and the consumer made a payment of $50 at the...

26 CFR 1.125-4 - Permitted election changes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the number of an employee's family members or dependents who may benefit from coverage under the plan... that individual becomes applicable or is increased under the family member plan. With respect to group... includes payments described in section 105(c). (5) Family member plan. A family member plan means a...

26 CFR 1.125-4 - Permitted election changes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the number of an employee's family members or dependents who may benefit from coverage under the plan... that individual becomes applicable or is increased under the family member plan. With respect to group... includes payments described in section 105(c). (5) Family member plan. A family member plan means a...

26 CFR 1.125-4 - Permitted election changes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the number of an employee's family members or dependents who may benefit from coverage under the plan... that individual becomes applicable or is increased under the family member plan. With respect to group... includes payments described in section 105(c). (5) Family member plan. A family member plan means a...

26 CFR 1.125-4 - Permitted election changes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the number of an employee's family members or dependents who may benefit from coverage under the plan... that individual becomes applicable or is increased under the family member plan. With respect to group... includes payments described in section 105(c). (5) Family member plan. A family member plan means a...

26 CFR 1.36B-0 - Table of contents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... health plan. (d) Family and family size. (e) Household income. (1) In general. (2) Modified adjusted... credit payment. (k) Exchange. (l) Self-only coverage. (m) Family coverage. (n) Rating area. (o) Effective...) Applicable benchmark plan. (1) In general. (2) Family coverage. (3) Silver level plan not covering a taxpayer...

26 CFR 1.36B-0 - Table of contents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... health plan. (d) Family and family size. (e) Household income. (1) In general. (2) Modified adjusted... credit payment. (k) Exchange. (l) Self-only coverage. (m) Family coverage. (n) Rating area. (o) Effective...) Applicable benchmark plan. (1) In general. (2) Family coverage. (3) Silver level plan not covering a taxpayer...

42 CFR 422.322 - Source of payment and effect of MA plan election on payment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Source of payment and effect of MA plan election on... Medicare Advantage Organizations § 422.322 Source of payment and effect of MA plan election on payment. (a) Source of payments. (1) Payments under this subpart for original fee-for-service benefits to MA...

42 CFR 422.322 - Source of payment and effect of MA plan election on payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Source of payment and effect of MA plan election on... Medicare Advantage Organizations § 422.322 Source of payment and effect of MA plan election on payment. (a) Source of payments. (1) Payments under this subpart for original fee-for-service benefits to MA...

42 CFR 422.322 - Source of payment and effect of MA plan election on payment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Source of payment and effect of MA plan election on... Medicare Advantage Organizations § 422.322 Source of payment and effect of MA plan election on payment. (a) Source of payments. (1) Payments under this subpart for original fee-for-service benefits to MA...

42 CFR 422.322 - Source of payment and effect of MA plan election on payment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Source of payment and effect of MA plan election on... Advantage Organizations § 422.322 Source of payment and effect of MA plan election on payment. (a) Source of payments. (1) Payments under this subpart for original fee-for-service benefits to MA organizations or MA...

42 CFR 422.322 - Source of payment and effect of MA plan election on payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Source of payment and effect of MA plan election on... Advantage Organizations § 422.322 Source of payment and effect of MA plan election on payment. (a) Source of payments. (1) Payments under this subpart for original fee-for-service benefits to MA organizations or MA...

77 FR 66915 - Amendment of Prohibited Payment Option Under Single-Employer Defined Benefit Plan of Plan Sponsor...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

... contains regulatory documents #0;having general applicability and legal effect, most of which are keyed #0.... These regulations affect administrators, employers, participants, and beneficiaries of such a plan... of the monthly amount paid under a single life annuity (plus any social security supplements...

25 CFR 171.560 - What if I fail to make payments as specified in my Payment Plan?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false What if I fail to make payments as specified in my Payment Plan? 171.560 Section 171.560 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND... Collections § 171.560 What if I fail to make payments as specified in my Payment Plan? (a) We will discontinue...

25 CFR 171.560 - What if I fail to make payments as specified in my Payment Plan?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false What if I fail to make payments as specified in my Payment Plan? 171.560 Section 171.560 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND... Collections § 171.560 What if I fail to make payments as specified in my Payment Plan? (a) We will discontinue...

Payment Reduction and Medicare Private Fee-for-Service Plans

PubMed Central

Frakt, Austin B.; Pizer, Steven D.; Feldman, Roger

2009-01-01

Medicare private fee-for-service (PFFS) plans are paid like other Medicare Advantage (MA) plans but are exempt from many MA requirements. Recently, Congress set average payments well above the costs of traditional fee-for-service (FFS) Medicare, inducing dramatic increases in PFFS plan enrollment. This has significant implications for Medicare's budget, provoking calls for policy change. We predict the effect of proposals to cut PFFS payments on PFFS plan participation and enrollment. We find that small reductions in payment rates would reduce PFFS participation and enrollment; if Congress reduces payments to traditional FFS levels it would cause the vast majority (85 percent) of PFFS plans to exit the market. PMID:19544932

76 FR 77767 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-14

...; post-exposure management and monitoring plans; scrapie test records; application for indemnity payments... authority to promulgate regulations designed to prevent the importation, preparation, sale, or shipment of... applications, product and test report forms and field study summaries. Need and Use of the Information: APHIS...

7 CFR 1770.17 - Expense matrix.

Code of Federal Regulations, 2010 CFR

2010-01-01

... compensation required by law; (4) Life, hospital, medical, dental, and vision plan insurance, and (5) Social... does not include payments for capital leases. (2) This subsidiary record category is applicable only to...

7 CFR 1770.17 - Expense matrix.

Code of Federal Regulations, 2011 CFR

2011-01-01

... compensation required by law; (4) Life, hospital, medical, dental, and vision plan insurance, and (5) Social... does not include payments for capital leases. (2) This subsidiary record category is applicable only to...

45 CFR 162.1701 - Health plan premium payments transaction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Health plan premium payments transaction. 162.1701 Section 162.1701 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Plan Premium Payments § 162.1701 Health plan...

45 CFR 162.1701 - Health plan premium payments transaction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Health plan premium payments transaction. 162.1701 Section 162.1701 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Plan Premium Payments § 162.1701 Health plan...

26 CFR 1.72-15 - Applicability of section 72 to accident or health plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... retirement and the payment of an earlier pension in the event of permanent disability. This section will also... presumed that the disability pension is provided by employer contributions, unless the plan expressly... or inclusion of accident or health benefits under sections 104 and 105. For example, the investment...

78 FR 15541 - Patient Protection and Affordable Care Act; Amendments to the HHS Notice of Benefit and Payment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... regulatory approach for de minimis variation standards, silver plan variations for individuals eligible for... structure in the applicable plan variation for which the individual is eligible. Under the second... Davies, Cathy D. Sherbourne, George A. Goldberg, Kathleen N. Lohr, Patricia Camp and Joseph P. Newhouse...

49 CFR 375.221 - May I use a charge or credit card plan for payments?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false May I use a charge or credit card plan for... card plan for payments? (a) You may provide in your tariff for the acceptance of charge or credit cards for the payment of freight charges. Accepting charge or credit card payments is different than...

49 CFR 375.221 - May I use a charge or credit card plan for payments?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 5 2013-10-01 2013-10-01 false May I use a charge or credit card plan for... card plan for payments? (a) You may provide in your tariff for the acceptance of charge or credit cards for the payment of freight charges. Accepting charge or credit card payments is different than...

49 CFR 375.221 - May I use a charge or credit card plan for payments?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 5 2012-10-01 2012-10-01 false May I use a charge or credit card plan for... card plan for payments? (a) You may provide in your tariff for the acceptance of charge or credit cards for the payment of freight charges. Accepting charge or credit card payments is different than...

49 CFR 375.221 - May I use a charge or credit card plan for payments?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 5 2014-10-01 2014-10-01 false May I use a charge or credit card plan for... card plan for payments? (a) You may provide in your tariff for the acceptance of charge or credit cards for the payment of freight charges. Accepting charge or credit card payments is different than...

49 CFR 375.221 - May I use a charge or credit card plan for payments?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false May I use a charge or credit card plan for... card plan for payments? (a) You may provide in your tariff for the acceptance of charge or credit cards for the payment of freight charges. Accepting charge or credit card payments is different than...

17 CFR 270.27h-1 - Exemptions from section 27(h)(4) for certain payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... monthly installment scheduled to be made during the life of the plan; and (2) “quarter” shall be the 3-month period which commences on the date a periodic payment plan is issued and each 3-month period... first payment on a periodic payment plan certificate which equals the amount of five minimum monthly...

45 CFR 162.1702 - Standards for health plan premium payments transaction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Standards for health plan premium payments transaction. 162.1702 Section 162.1702 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Plan Premium Payments § 162.1702 Standards for health plan premium...

45 CFR 162.1702 - Standards for health plan premium payments transaction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Standards for health plan premium payments transaction. 162.1702 Section 162.1702 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Plan Premium Payments § 162.1702 Standards for health plan premium...

45 CFR 162.1702 - Standards for health plan premium payments transaction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Standards for health plan premium payments transaction. 162.1702 Section 162.1702 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Plan Premium Payments § 162.1702 Standards for health plan premium...

45 CFR 162.1702 - Standards for health plan premium payments transaction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Standards for health plan premium payments transaction. 162.1702 Section 162.1702 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Plan Premium Payments § 162.1702 Standards for health plan premium...

Integrating Risk Adjustment and Enrollee Premiums in Health Plan Payment

PubMed Central

McGuire, Thomas G.; Glazer, Jacob; Newhouse, Joseph P.; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D.; Zuvekas, Samuel

2013-01-01

In two important health policy contexts – private plans in Medicare and the new state-run “Exchanges” created as part of the Affordable Care Act (ACA) – plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

42 CFR 422.216 - Special rules for MA private fee-for-service 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 private fee-for-service plans... With Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and...

42 CFR 422.216 - Special rules for MA private fee-for-service 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 private fee-for-service plans... With Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and...

42 CFR 422.216 - Special rules for MA private fee-for-service 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 private fee-for-service plans... With Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and...

14 CFR 151.129 - Payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151.129 Payments. (a) The United States' share of advance planning costs is paid in two installments unless the advance planning grant agreement provides otherwise. Upon request by sponsor, the first payment may be...

Disability payments continue to climb: "Tell us what you see, not what you think," CPP tells MDs

PubMed Central

Baer, N

1997-01-01

Growing concern about the sustainability of the Canada Pension Plan has led to a closer look at the disability benefits it provides. The federal auditor general reported recently that the number of recipients has almost doubled in the past 10 years, and disability payments have more than tripled, to $3 billion annually. This article looks at the role physicians play in determining whether an applicant is disabled. PMID:9006568

42 CFR 410.152 - Amounts of payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Payment of SMI Benefits § 410.152 Amounts of payment. (a) General... special rules for payment to health maintenance organizations (HMOs), health care prepayment plans (HCPPs), and competitive medical plans (CMPs) that are set forth in part 417 of this chapter. (A prepayment...

25 CFR 171.560 - What if I fail to make payments as specified in my Payment Plan?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false What if I fail to make payments as specified in my... AND WATER IRRIGATION OPERATION AND MAINTENANCE Financial Matters: Assessments, Billing, and Collections § 171.560 What if I fail to make payments as specified in my Payment Plan? (a) We will discontinue...

25 CFR 171.560 - What if I fail to make payments as specified in my Payment Plan?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What if I fail to make payments as specified in my... AND WATER IRRIGATION OPERATION AND MAINTENANCE Financial Matters: Assessments, Billing, and Collections § 171.560 What if I fail to make payments as specified in my Payment Plan? (a) We will discontinue...

42 CFR 422.216 - Special rules for MA private fee-for-service 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 private fee-for-service plans... Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and services that...

42 CFR 422.216 - Special rules for MA private fee-for-service 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 private fee-for-service plans... Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and services that...

Do Students Need a Deferred Tuition Payment Plan?

ERIC Educational Resources Information Center

Duplass, James A.

1984-01-01

Wayne State University's experiences in altering its deferred tuition payment plan to improve cash flow but not adversely affect enrollment are outlined and analyzed. The new plan saved money for the university and encouraged early registration, and most students opted to prepay tuition, saving the late payment fee. (MSE)

Integrating risk adjustment and enrollee premiums in health plan payment.

PubMed

McGuire, Thomas G; Glazer, Jacob; Newhouse, Joseph P; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D; Zuvekas, Samuel H

2013-12-01

In two important health policy contexts - private plans in Medicare and the new state-run "Exchanges" created as part of the Affordable Care Act (ACA) - plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). Copyright © 2013 Elsevier B.V. All rights reserved.

42 CFR 422.208 - Physician incentive plans: requirements and limitations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... difference between the maximum potential payments and the minimum potential payments is more than 25 percent... have the effect of reducing or limiting the services provided to any plan enrollee. Potential payments... considered in this determination. (2) Risk threshold. The risk threshold is 25 percent of potential payments...

42 CFR 422.208 - Physician incentive plans: requirements and limitations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... difference between the maximum potential payments and the minimum potential payments is more than 25 percent... have the effect of reducing or limiting the services provided to any plan enrollee. Potential payments... considered in this determination. (2) Risk threshold. The risk threshold is 25 percent of potential payments...

42 CFR 422.208 - Physician incentive plans: requirements and limitations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... difference between the maximum potential payments and the minimum potential payments is more than 25 percent... have the effect of reducing or limiting the services provided to any plan enrollee. Potential payments... considered in this determination. (2) Risk threshold. The risk threshold is 25 percent of potential payments...

Results, Knowledge, and Attitudes Regarding an Incentive Compensation Plan in a Hospital-Based, Academic, Employed Physician Multispecialty Group.

PubMed

Dolan, Robert W; Nesto, Richard; Ellender, Stacey; Luccessi, Christopher

Hospitals and healthcare systems are introducing incentive metrics into compensation plans that align with value-based payment methodologies. These incentive measures should be considered a practical application of the transition from volume to value and will likely replace traditional productivity-based compensation in the future. During the transition, there will be provider resistance and implementation challenges. This article examines a large multispecialty group's experience with a newly implemented incentive compensation plan including the structure of the plan, formulas for calculation of the payments, the mix of quality and productivity metrics, and metric threshold achievement. Three rounds of surveys with comments were collected to measure knowledge and attitudes regarding the plan. Lessons learned and specific recommendations for success are described. The participant's knowledge and attitudes regarding the plan are important considerations and affect morale and engagement. Significant provider dissatisfaction with the plan was found. Careful metric selection, design, and management are critical activities that will facilitate provider acceptance and support. Improvements in data collection and reporting will be needed to produce reliable metrics that can supplant traditional volume-based productivity measures.

12 CFR 7.1018 - Automatic payment plan account.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Automatic payment plan account. 7.1018 Section 7.1018 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY BANK ACTIVITIES AND OPERATIONS Bank Powers § 7.1018 Automatic payment plan account. A national bank may, for the benefit and...

5 CFR 550.1205 - Calculating a lump-sum payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the annual rate of pay by 2,087 (or 2,756 for firefighters, if applicable) and rounding it to the... States Code; and savings under the Thrift Savings Plan established by subchapter III of chapter 84 of...

5 CFR 550.1205 - Calculating a lump-sum payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the annual rate of pay by 2,087 (or 2,756 for firefighters, if applicable) and rounding it to the... States Code; and savings under the Thrift Savings Plan established by subchapter III of chapter 84 of...

5 CFR 550.1205 - Calculating a lump-sum payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the annual rate of pay by 2,087 (or 2,756 for firefighters, if applicable) and rounding it to the... States Code; and savings under the Thrift Savings Plan established by subchapter III of chapter 84 of...

5 CFR 550.1205 - Calculating a lump-sum payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the annual rate of pay by 2,087 (or 2,756 for firefighters, if applicable) and rounding it to the... States Code; and savings under the Thrift Savings Plan established by subchapter III of chapter 84 of...

42 CFR 422.304 - Monthly payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... an MA-PD plan, defined at § 422.252, the MA organization offering such a plan also receives- (1... payments of the amounts determined under paragraphs (a)(1) and (a)(2) of this section for coverage of original fee-for-service benefits for an individual in an MA payment area for a month. (1) Payment of bid...

Inventory model with two rates of production for deteriorating items with permissible delay in payments

NASA Astrophysics Data System (ADS)

Roy, Ajanta; Samanta, G. P.

2011-08-01

Goyal (1985) ['Economic Order Quantity Under Conditions of Permissible Delay in Payments', Journal of Operational research Society, 36, 35-38] assumed that unit selling price and unit purchasing price are equal. But in real-life the scenario is different. The purpose of this article is to reflect the real life problem by allowing unit selling price and purchasing price to be unequal. Our model is a continuous production control inventory model for deteriorating items in which two different rates of production are available. The results are illustrated with the help of a numerical example. We discuss the sensitivity of the solution together with the changes of the values of the parameters associated with the model. Our model may be applicable in many manufacturing planning situations where management practices for deterioration are stringent; e.g. the two-production rate will be more profitable than the one-production rate in the manufacture of cold, asthma and allergy medicine. Our proposed model might be applicable to develop a prototype advance planning system for those manufacturers to integrate the management science techniques into commercial planning.

Report on Sandia Corporation defined benefit pension plans, Albuquerque, New Mexico

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1986-12-12

This report concerns payments by the Sandia Corporation to employee pension plans. The audit disclosed that in 1984 the Department incurred unnecessary costs of $19.2 million because Sandia made payments into its two pension plans even though information contained in Sandia'a actuarial consultants' reports showed that the funds were overfunded by $77.7 million at the beginning of the year. During the preceding three years, similar payments were made which added to plan overfunding. Sandia had based pension plan payments on very conservative actuarial assumptions. Albuquerque did not agree with the findings and recommendations. A summary of management's comments and themore » response are included in the report.« less

[Concept for Planning the Nurse-Patient Ratio and Nursing Fee Payment Linkage System].

PubMed

Lu, Meei-Shiow; Tseng, Hsiu-Yi; Liang, Shu-Yuan; Lin, Chiou-Fen

2017-02-01

This article describes the current situation in Taiwan with regard to the nurse-patient ratio and nursing fee payments, reviews the related policies and results in developed countries, and then proposes a plan for improving the domestic situation. Direct relationships exist between patient nursing quality and patient safety and the nurse-patient ratio as well as between nursing fee payments and the nurse-patient ratio. Therefore, in order to enhance the quality and safety of nursing care, it will be necessary to develop and institute a payment linkage system that links nursing fee payments to the nurse-patient ratio. This process requires public consensus and planning in order to institute an equitable and effective payment linkage system in the future.

The impact of health reform on the Medicare Advantage program: realigning payment with performance.

PubMed

Biles, Brian; Casillas, Giselle; Arnold, Grace; Guterman, Stuart

2012-10-01

The Affordable Care Act enacts a new payment system for private health plans available to Medicare beneficiaries through the Medicare Advantage (MA) program. The system, which is being phased in through 2017, aims to (1) reduce the excess pay­ments received by private plans relative to per capita spending in traditional Medicare, and (2) reward plans that earn high performance ratings. Using 2009 data, this issue brief pres­ents analysis of the distributional impact on MA plan payments of these new policies as if they had been fully implemented in that year. We find that, when the polices [sic] are in place, they will bring overall MA plan payments nationwide down from 114 percent to 102 per­cent of what spending would have been for the same enrollees if they had been enrolled in traditional Medicare. While payments will vary across the nation, high-performing MA plans stand to benefit from this new arrangement.

Higher Incentive Payments in Medicare Advantage's Pay-for-Performance Program Did Not Improve Quality But Did Increase Plan Offerings.

PubMed

Layton, Timothy J; Ryan, Andrew M

2015-12-01

To evaluate the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. Publicly available data from CMS from 2009 to 2014 on Medicare Advantage plan quality ratings, the counties in the service area of each plan, and the benchmarks used to construct plan payments. The Medicare Advantage Quality Bonus Payment Demonstration began in 2012. Under the Demonstration, all Medicare Advantage plans were eligible to receive bonus payments based on plan-level quality scores (star ratings). In some counties, plans were eligible to receive bonus payments that were twice as large as in other counties. We used this variation in incentives to evaluate the effects of bonus size on star ratings and the number of plan offerings in the Demonstration using a differences-in-differences identification strategy. We used matching to create a comparison group of counties that did not receive double bonuses but had similar levels of the preintervention outcomes. Results from the difference-in-differences analysis suggest that the receipt of double bonuses was not associated with an increase in star ratings. In the matched sample, the receipt of double bonuses was associated with a statistically insignificant increase of +0.034 (approximately 1 percent) in the average star rating (p > .10, 95 percent CI: -0.015, 0.083). In contrast, the receipt of double bonuses was associated with an increase in the number of plans offered. In the matched sample, the receipt of double bonuses was associated with an overall increase of +0.814 plans (approximately 5.8 percent) (p < .05, 95 percent CI: 0.078, 1.549). We estimate that the double bonuses increased payments by $3.43 billion over the first 3 years of the Demonstration. At great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings. © Health Research and Educational Trust.

42 CFR 422.300 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for making payments to Medicare Advantage (MA) organizations offering local and regional MA plans, including calculation of MA capitation rates and benchmarks, conditions under which payment is based on plan....458 in subpart J for rules on risk sharing payments to MA regional organizations. ...

20 CFR 404.1052 - Payments from or to certain tax-exempt trusts or payments under or into certain annuity plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Payments from or to certain tax-exempt trusts or payments under or into certain annuity plans. 404.1052 Section 404.1052 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Incom...

29 CFR 4050.6 - Payment and required documentation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... MISSING PARTICIPANTS § 4050.6 Payment and required documentation. (a) Time of payment and filing. The plan... administrator and the plan's enrolled actuary) specified in the missing participant forms and instructions, by the time the post-distribution certification is due. Except as otherwise provided in the missing...

29 CFR 4050.6 - Payment and required documentation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MISSING PARTICIPANTS § 4050.6 Payment and required documentation. (a) Time of payment and filing. The plan... administrator and the plan's enrolled actuary) specified in the missing participant forms and instructions, by the time the post-distribution certification is due. Except as otherwise provided in the missing...

Calculating five types of typical underpayments.

PubMed

Welter, T; Stevenson, P

2001-10-01

Underpayments to providers under their payer agreements are a cause of many thousands of dollars in lost revenue. Providers should devise a plan to make certain that payments made to them are accurate, on time, and adhere to other contractual obligations. The importance of developing and implementing such a plan is substantiated by the fact that nearly 100 percent of a provider's commercial business is under contract. As a starting point, providers may wish to focus on five common types of underpayments: underfunding due to late payments; fee-schedule changes that are contractually disallowed; miscalculation of performance-based bonuses and errors in risk-payment reconciliations; inappropriate denials or inappropriate downcoding of claims; and non-payments. The successful execution of a plan to identify and resolve problems and recover payments owed relies on the provider's ability to document and prove that payment is due.

42 CFR 422.208 - Physician incentive plans: requirements and limitations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of reducing or limiting the services provided to any plan enrollee. Potential payments means the... determination. (2) Risk threshold. The risk threshold is 25 percent of potential payments. (3) Arrangements that...) Withholds greater than 25 percent of potential payments. (ii) Withholds less than 25 percent of potential...

42 CFR 422.208 - Physician incentive plans: requirements and limitations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of reducing or limiting the services provided to any plan enrollee. Potential payments means the... determination. (2) Risk threshold. The risk threshold is 25 percent of potential payments. (3) Arrangements that...) Withholds greater than 25 percent of potential payments. (ii) Withholds less than 25 percent of potential...

42 CFR 59.207 - Payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Payments. 59.207 Section 59.207 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.207 Payments. The Secretary shall from time to time make...

42 CFR 59.207 - Payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Payments. 59.207 Section 59.207 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.207 Payments. The Secretary shall from time to time make...

42 CFR 59.207 - Payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Payments. 59.207 Section 59.207 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.207 Payments. The Secretary shall from time to time make...

42 CFR 59.207 - Payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Payments. 59.207 Section 59.207 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.207 Payments. The Secretary shall from time to time make...

42 CFR 59.207 - Payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Payments. 59.207 Section 59.207 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.207 Payments. The Secretary shall from time to time make...

26 CFR 1.409A-3 - Permissible payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... schedule of periodic payments on a dollar-for-dollar basis by the amount of bona fide disability pay..., objective formula limitation, if the disability payments are made pursuant to a plan sponsored by the... other change in the benefit payable under, such bona fide disability plan results in an acceleration of...

42 CFR 422.304 - Monthly payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... makes advance monthly payments of the amounts determined under paragraphs (a)(1) and (a)(2) of this... month. (1) Payment of bid for plans with bids below benchmark. For MA plans that have average per capita... benchmarks. The rebate amount under paragraph (a)(1)(ii) of this section is the amount of the monthly rebate...

42 CFR 422.304 - Monthly payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... makes advance monthly payments of the amounts determined under paragraphs (a)(1) and (a)(2) of this... month. (1) Payment of bid for plans with bids below benchmark. For MA plans that have average per capita... benchmarks. The rebate amount under paragraph (a)(1)(ii) of this section is the amount of the monthly rebate...

42 CFR 422.304 - Monthly payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... makes advance monthly payments of the amounts determined under paragraphs (a)(1) and (a)(2) of this... month. (1) Payment of bid for plans with bids below benchmark. For MA plans that have average per capita... benchmarks. The rebate amount under paragraph (a)(1)(ii) of this section is the amount of the monthly rebate...

29 CFR 825.212 - Employee failure to pay health plan premium payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Family and Medical Leave Act § 825.212 Employee failure to pay health plan premium payments. (a)(1) In... obligations to maintain health insurance coverage cease under FMLA if an employee's premium payment is more... an employee's insurance in accordance with this section and fails to restore the employee's health...

29 CFR 4007.8 - Late payment penalty charges.

Code of Federal Regulations, 2010 CFR

2010-07-01

... administrator reports— (i) The fair market value of the plan's assets for the premium payment year, and (ii) An estimate of the plan's premium funding target for the premium payment year that is certified by an enrolled... determined from the value of assets and estimated premium funding target so reported. [64 FR 66385, Nov. 26...

A comparison of mail-service and retail community pharmacy claims in 5 prescription benefit plans.

PubMed

Clark, Bartholomew E; Siracuse, Mark V; Garis, Robert I

2009-06-01

Little evidence has been presented to date that would either support or refute a widely held belief that mail-service pharmacy utilization routinely produces savings in drug benefit costs for prescription benefit plan sponsors. To present a comparative analysis of mail-service and community pharmacy service drug benefit costs for 5 employer-sponsored prescription drug benefit plans. A cross-sectional comparison of 17,725 matched transaction pairs of community and mail-service prescriptions from a data set comprised 484,987 prescription claims from a convenience sample of 5 employer-sponsored prescription benefit plans. Differences between community pharmacy and mail-service prescription transactions were examined at the per-unit level of analysis for drug ingredient costs, dispensing fees, co-payments, dollar amounts paid by plan sponsor, and total dollar amounts. Overall, the total cost of prescriptions was lower through mail-service pharmacies for all 5 plans studied. Two of 5 plans had co-payment incentives to use mail-service, yet plan sponsors paid more for mail-service drugs; respectively, 4.5% and 8.3% more overall, 25.0% and 21.4% more for generic medications; and 3.0% and 7.0% more for brand name medications. Mail-service co-payments were 48.9% and 51.7% lower. Mail-service utilization rates were 15.2% and 31.5% of the total number of prescriptions dispensed in the period studied. Three of 5 plans had no co-payment incentive to use mail-service and paid less for mail-service drugs; respectively, 18.7%, 6.6%, and 15.7% less overall; 17.4%, 15.6%, and 7.9% less for generic medications; and 18.8%, 5.2%, and 16.6% less for brand name medications. Mail-service co-payments were 10.5% more, 5.2% less, and 1.8% more than community pharmacy co-payments, respectively. Mail-service utilization rates were 0.8%, 1.2%, and 4.4%. Co-payment incentives to use mail-service pharmacies instead of community pharmacies were associated with higher mail-service utilization rates and with higher costs to plan sponsors. Absence of a co-payment incentive to use mail-service pharmacies was associated with lower mail-service utilization rates and with lower costs to plan sponsors.

7 CFR 762.120 - Applicant eligibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

...; discharge in bankruptcy; or through payment of a guaranteed loss claim on: (i) More than three occasions on... reorganization plan under chapter 11, 12, or 13 of title 11 of the United States Code; or (iii) Received debt... debt within three years after the designation of such emergency meet this exception. (b) Delinquent...

7 CFR Appendix D to Subpart E of... - Alcohol Production Facilities Planning, Performing, Development and Project Control

Code of Federal Regulations, 2013 CFR

2013-01-01

... impacts. (2) Applicable engineering, design/build, construction management, inspection and plant start-up... imposed by construction, equipment, material or service contracts, penalty payments, damage claims, awards... consultants with suitable experience, training and professional competence in the design and construction of...

7 CFR Appendix D to Subpart E of... - Alcohol Production Facilities Planning, Performing, Development and Project Control

Code of Federal Regulations, 2010 CFR

2010-01-01

... impacts. (2) Applicable engineering, design/build, construction management, inspection and plant start-up... imposed by construction, equipment, material or service contracts, penalty payments, damage claims, awards... consultants with suitable experience, training and professional competence in the design and construction of...

Medicaid Integrity Program; eligible entity and contracting requirements for the Medicaid Integrity audit program. Final rule.

PubMed

2008-09-26

Section 1936 of the Social Security Act (the Act) (as added by section 6034 of the Deficit Reduction Act of 2005 (DRA) established the Medicaid Integrity Program to promote the integrity of the Medicaid program by requiring CMS to enter into contracts with eligible entities to: (1) Review the actions of individuals or entities furnishing items or services (whether on a fee-for-service, risk, or other basis) for which payment may be made under an approved State plan and/or any waiver of such plan approved under section 1115 of the Act; (2) audit claims for payment of items or services furnished, or administrative services rendered, under a State plan; (3) identify overpayments to individuals or entities receiving Federal funds; and (4) educate providers of services, managed care entities, beneficiaries, and other individuals with respect to payment integrity and quality of care. This final rule will provide requirements for an eligible entity to enter into a contract under the Medicaid integrity audit program. The final rule will also establish the contracting requirements for eligible entities. The requirements will include procedures for identifying, evaluating, and resolving organizational conflicts of interest that are generally applicable to Federal acquisition and procurement; competitive procedures to be used; and procedures under which a contract may be renewed.

31 CFR 29.334 - Deposit service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Firefighters Plan. No credit is allowed for Federal Benefit Payments under the Police and Firefighters Plan for... Satisfied by June 30, 1997 § 29.334 Deposit service. (a) Teachers Plan. (1) Periods of civilian service that... Benefit Payments under the Teachers Plan if the deposit for the service was paid in full to the Teachers...

31 CFR 29.334 - Deposit service.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Firefighters Plan. No credit is allowed for Federal Benefit Payments under the Police and Firefighters Plan for... Satisfied by June 30, 1997 § 29.334 Deposit service. (a) Teachers Plan. (1) Periods of civilian service that... Benefit Payments under the Teachers Plan if the deposit for the service was paid in full to the Teachers...

31 CFR 29.334 - Deposit service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Firefighters Plan. No credit is allowed for Federal Benefit Payments under the Police and Firefighters Plan for... Satisfied by June 30, 1997 § 29.334 Deposit service. (a) Teachers Plan. (1) Periods of civilian service that... Benefit Payments under the Teachers Plan if the deposit for the service was paid in full to the Teachers...

Budget model can aid group practice planning.

PubMed

Bender, A D

1991-12-01

A medical practice can enhance its planning by developing a budgetary model to test effects of planning assumptions on its profitability and cash requirements. A model focusing on patient visits, payment mix, patient mix, and fee and payment schedules can help assess effects of proposed decisions. A planning model is not a substitute for planning but should complement a plan that includes mission, goals, values, strategic issues, and different outcomes.

Opportunities and Challenges for Payment Reform: Observations from Massachusetts.

PubMed

Mechanic, Robert E

2016-08-01

Policy makers and private health plans are expanding their efforts to implement new payment models that will encourage providers to improve quality and deliver health care more efficiently. Over the past five years, payment reforms have progressed faster in Massachusetts than in any other state. The reasons include a major effort by Blue Cross Blue Shield of Massachusetts to implement global payment, the presence of large integrated systems willing to take on financial risk, and a supportive state policy environment. By 2014, thirty-seven percent of Massachusetts's residents enrolled in health plans were covered under risk-based payment models tied to global budgets. But the expansion of payment reform in Massachusetts slowed between 2012 and 2015 because some commercial enrollment shifted from risk-based health maintenance organization products to fee-for-service preferred provider organization (PPO) plans, and the state Medicaid program fell short of its payment reform goals. Provider groups will not fully commit to population-based clinical models if they believe it will result in large reductions in fee-for-service revenue. The use of alternative payment models will accelerate in 2016 when Blue Cross begins implementing PPO payment reforms, but it is unknown how quickly other payers will follow. Massachusetts's experience illustrates the complexity of payment reform in pluralistic health care markets and the need for complementary efforts by public and private stakeholders. Copyright © 2016 by Duke University Press.

The impact of the Affordable Care Act on Medicare Advantage plan availability and enrollment.

PubMed

Afendulis, Christopher C; Landrum, Mary Beth; Chernew, Michael E

2012-12-01

To assess the impact of the Patient Protection and Affordable Care Act's (ACA) changes in Medicare Advantage (MA) payment rates on the availability of and enrollment in MA plans. Secondary data on MA plan offerings, contract offerings, and enrollment by state and county, in 2010-2011. We estimated regression models of the change in the number of plans, the number of contracts, and enrollment as a function of quartiles of FFS spending and pre-ACA MA payment generosity. Counties in the lowest quartile of spending are treated most generously by the ACA. Relative to counties in the highest quartile of spending, the number of plans in counties in the first, second, and third quartiles rose by 12 percent, 7.6 percent, and 5.4 percent, respectively. Counties with more generous MA payment rates before the ACA lost significantly more plans. We did not find a similar impact on the change in contracts or enrollment. The ACA-induced MA payment changes reduced the number of plan choices available for Medicare beneficiaries, but they have yet affected enrollment patterns. © Health Research and Educational Trust.

29 CFR 2509.78-1 - Interpretive bulletin relating to payments by certain employee welfare benefit plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... employee welfare benefit plans. 2509.78-1 Section 2509.78-1 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR GENERAL INTERPRETIVE BULLETINS RELATING TO... payments by certain employee welfare benefit plans. The Department of Labor today announced its...

42 CFR 447.272 - Inpatient services: Application of upper payment limits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... inpatient services furnished by hospitals, nursing facilities, and ICFs/MR within one of the following... are funded through the Indian Self-Determination and Education Assistance Act (Pub. L. 93-638). (2... hospitals, nursing facilities and ICFs/MR “ Medicaid State plan rate year 2008. (2) For all other facilities...

45 CFR 233.107 - Restriction in payment to households headed by a minor parent.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Restriction in payment to households headed by a... Restriction in payment to households headed by a minor parent. (a) State plan requirements. A State in its... for assistance paid under the State plan to a pregnant woman as provided in § 233.90(c)(2)(iv) of this...

7 CFR 1469.23 - Program payments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION SECURITY PROGRAM Contracts and Payments § 1469.23 Program payments. (a) Stewardship component of CSP payments. (1) The conservation stewardship plan... Agriculture Statistics Service (NASS) land rental data, and Conservation Reserve Program (CRP) rental rates...

16 CFR 240.8 - Need for a plan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Need for a plan. 240.8 Section 240.8 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES FOR ADVERTISING ALLOWANCES AND OTHER MERCHANDISING PAYMENTS AND SERVICES § 240.8 Need for a plan. A seller who makes payments...

Diagnostic Risk Adjustment for Medicaid: The Disability Payment System

PubMed Central

Kronick, Richard; Dreyfus, Tony; Lee, Lora; Zhou, Zhiyuan

1996-01-01

This article describes a system of diagnostic categories that Medicaid programs can use for adjusting capitation payments to health plans that enroll people with disability. Medicaid claims from Colorado, Michigan, Missouri, New York, and Ohio are analyzed to demonstrate that the greater predictability of costs among people with disabilities makes risk adjustment more feasible than for a general population and more critical to creating health systems for people with disability. The application of our diagnostic categories to State claims data is described, including estimated effects on subsequent-year costs of various diagnoses. The challenges of implementing adjustment by diagnosis are explored. PMID:10172665

31 CFR 256.41 - When is reimbursement due for CDA and No FEAR payments?

Code of Federal Regulations, 2010 CFR

2010-07-01

... No FEAR payments? 256.41 Section 256.41 Money and Finance: Treasury Regulations Relating to Money and... When is reimbursement due for CDA and No FEAR payments? Reimbursement for a CDA or No FEAR payment... Management (OPM) regulations, No FEAR reimbursements or payment reimbursement plans must be made within 45...

26 CFR 54.4980H-5 - Assessable payments under section 4980H(b).

Code of Federal Regulations, 2014 CFR

2014-04-01

.... (iii) Rate of pay safe harbor. An applicable large employer member satisfies the rate of pay safe... of the employee's hourly rate of pay as of the first day of the coverage period (generally the first day of the plan year) or the employee's lowest hourly rate of pay during the calendar month. An...

7 CFR 1948.57 - Eligible activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Education plans; and (vi) Subdivision plans. (3) Payment of salaries of professional, technical, and... to undertake tests, make appraisals, and arrange for engineering/architectural services necessary for...) Necessary engineering reports in connection with site development; (7) Payment of costs to undertake tests...

42 CFR 484.205 - Basis of payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... episode payment (PEP) adjustment due to an intervening event defined as a beneficiary elected transfer or... new physician certification of the new plan of care. The PEP adjustment is determined in accordance with § 484.235. (3) An outlier payment is determined in accordance with § 484.240. (b) Episode payment...

42 CFR 484.205 - Basis of payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... episode payment (PEP) adjustment due to an intervening event defined as a beneficiary elected transfer or... new physician certification of the new plan of care. The PEP adjustment is determined in accordance with § 484.235. (3) An outlier payment is determined in accordance with § 484.240. (b) Episode payment...

42 CFR 484.205 - Basis of payment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... episode payment (PEP) adjustment due to an intervening event defined as a beneficiary elected transfer or... new physician certification of the new plan of care. The PEP adjustment is determined in accordance with § 484.235. (3) An outlier payment is determined in accordance with § 484.240. (b) Episode payment...

42 CFR 484.205 - Basis of payment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... episode payment (PEP) adjustment due to an intervening event defined as a beneficiary elected transfer or... new physician certification of the new plan of care. The PEP adjustment is determined in accordance with § 484.235. (3) An outlier payment is determined in accordance with § 484.240. (b) Episode payment...

42 CFR 484.205 - Basis of payment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... episode payment (PEP) adjustment due to an intervening event defined as a beneficiary elected transfer or... new physician certification of the new plan of care. The PEP adjustment is determined in accordance with § 484.235. (3) An outlier payment is determined in accordance with § 484.240. (b) Episode payment...

Customer loyalty among daily disposable contact lens wearers.

PubMed

Patel, Neelam I; Naroo, Shehzad A; Eperjesi, Frank; Rumney, Nicholas J

2015-02-01

Optometric practices offer contact lenses as cash sale items or as part of monthly payment plans. With the contact lens market becoming increasingly competitive, patients are opting to purchase lenses from supermarkets and Internet suppliers. Monthly payment plans are often implemented to improve loyalty. This study aimed to compare behavioural loyalty between monthly payment plan members and non-members. BBR Optometry Ltd offers a monthly payment plan (Eyelife™) to their contact lens wearers. A retrospective audit of 38 Eyelife™ members (mean±SD: 42.7±15.0 years) and 30 non-members (mean±SD: 40.8±16.7 years) was conducted. Revenue and profits generated, service uptake and product sales between the two groups were compared over a fixed period of 18 months. Eyelife™ members generated significantly higher professional fee revenue (P<0.001), £153.96 compared to £83.50, and profits (P<0.001). Eyelife™ members had a higher uptake of eye examinations (P<0.001). The 2 groups demonstrated no significant difference in spectacle sales by volume (P=0.790) or value (P=0.369). There were also no significant differences in contact lens revenue (P=0.337), although Eyelife™ members did receive a discount. The Eyelife™ group incurred higher contact lens costs (P=0.037), due to a greater volume of contact lens purchases, 986 units compared to 582. Monthly payment plans improve loyalty among contact lens wearers, particularly service uptake and volume of lens purchases. Additionally the greater professional fees generated, render monthly payment plans an attractive business model and practice builder. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Integrating Personalized and Community Services for Mobile Travel Planning and Management

NASA Astrophysics Data System (ADS)

Yu, Chien-Chih

Personalized and community services have been noted as keys to enhance and facilitate e-tourism as well as mobile applications. This paper aims at proposing an integrated service framework for combining personalized and community functions to support mobile travel planning and management. Major mobile tourism related planning and decision support functions specified include personalized profile management, information search and notification, evaluation and recommendation, do-it-yourself planning and design, community and collaboration management, auction and negotiation, transaction and payment, as well as trip tracking and quality control. A system implementation process with an example prototype is also presented for illustrating the feasibility and effectiveness of the proposed system framework, process model, and development methodology.

29 CFR 825.210 - Employee payment of group health benefit premiums.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Employee payment of group health benefit premiums. 825.210... and Medical Leave Act § 825.210 Employee payment of group health benefit premiums. (a) Group health... make arrangements with the employer for payment of group health plan benefits when simultaneously...

29 CFR 825.210 - Employee payment of group health benefit premiums.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Employee payment of group health benefit premiums. 825.210... and Medical Leave Act § 825.210 Employee payment of group health benefit premiums. (a) Group health... arrangements with the employer for payment of group health plan benefits when simultaneously taking FMLA leave...

29 CFR 825.210 - Employee payment of group health benefit premiums.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Employee payment of group health benefit premiums. 825.210... and Medical Leave Act § 825.210 Employee payment of group health benefit premiums. (a) Group health... arrangements with the employer for payment of group health plan benefits when simultaneously taking FMLA leave...

29 CFR 825.210 - Employee payment of group health benefit premiums.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Employee payment of group health benefit premiums. 825.210... and Medical Leave Act § 825.210 Employee payment of group health benefit premiums. (a) Group health... make arrangements with the employer for payment of group health plan benefits when simultaneously...

45 CFR 1355.57 - Cost allocation.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE...) All expenditures of a title IV-E agency to plan, design, develop, install, and operate the data... care maintenance payments or adoption assistance payments may be made under the title IV-E plan. (b...

7 CFR 4280.119 - Construction planning and performing development.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Energy for America Program General Renewable Energy System and Energy Efficiency Improvement Grants... planning, designing, bidding, contracting, and constructing renewable energy systems and energy efficiency... payment. Partial payments will be made in accordance with Form RD 4280-2 and Form RD 1924-6, “Construction...

7 CFR 4280.119 - Construction planning and performing development.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Energy for America Program General Renewable Energy System and Energy Efficiency Improvement Grants... planning, designing, bidding, contracting, and constructing renewable energy systems and energy efficiency... payment. Partial payments will be made in accordance with Form RD 4280-2 and Form RD 1924-6, “Construction...

7 CFR 4280.119 - Construction planning and performing development.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Energy for America Program General Renewable Energy System and Energy Efficiency Improvement Grants... planning, designing, bidding, contracting, and constructing renewable energy systems and energy efficiency... payment. Partial payments will be made in accordance with Form RD 4280-2 and Form RD 1924-6, “Construction...

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...

42 CFR 414.39 - Special rules for payment of care plan oversight.

Code of Federal Regulations, 2013 CFR

2013-10-01

... this section a nonphysician practitioner (NPP) is a nurse practitioner, clinical nurse specialist or physician assistant. (b) Exception. Separate payment is made under the following conditions for physician... the NPP is a nurse practitioner or clinical nurse specialist, the physician signing the plan of care...

42 CFR 414.39 - Special rules for payment of care plan oversight.

Code of Federal Regulations, 2012 CFR

2012-10-01

... this section a nonphysician practitioner (NPP) is a nurse practitioner, clinical nurse specialist or physician assistant. (b) Exception. Separate payment is made under the following conditions for physician... the NPP is a nurse practitioner or clinical nurse specialist, the physician signing the plan of care...

42 CFR 414.39 - Special rules for payment of care plan oversight.

Code of Federal Regulations, 2010 CFR

2010-10-01

... this section a nonphysician practitioner (NPP) is a nurse practitioner, clinical nurse specialist or physician assistant. (b) Exception. Separate payment is made under the following conditions for physician... the NPP is a nurse practitioner or clinical nurse specialist, the physician signing the plan of care...

42 CFR 414.39 - Special rules for payment of care plan oversight.

Code of Federal Regulations, 2011 CFR

2011-10-01

... this section a nonphysician practitioner (NPP) is a nurse practitioner, clinical nurse specialist or physician assistant. (b) Exception. Separate payment is made under the following conditions for physician... the NPP is a nurse practitioner or clinical nurse specialist, the physician signing the plan of care...

42 CFR 414.39 - Special rules for payment of care plan oversight.

Code of Federal Regulations, 2014 CFR

2014-10-01

... this section a nonphysician practitioner (NPP) is a nurse practitioner, clinical nurse specialist or physician assistant. (b) Exception. Separate payment is made under the following conditions for physician... the NPP is a nurse practitioner or clinical nurse specialist, the physician signing the plan of care...

76 FR 11827 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

... account. Rule 27d-1(j) directs depositors and principal underwriters annually to make an accounting of... depositor or principal underwriter for an issuer of periodic payment plans to deposit funds into a... depositors or principal underwriters for the issuers of periodic payment plans. In order to comply with the...

20 CFR 404.1052 - Payments from or to certain tax-exempt trusts or payments under or into certain annuity plans.

Code of Federal Regulations, 2012 CFR

2012-04-01

... SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Wages § 404.1052 Payments from or to certain tax-exempt...

20 CFR 404.1052 - Payments from or to certain tax-exempt trusts or payments under or into certain annuity plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Wages § 404.1052 Payments from or to certain tax-exempt...

20 CFR 404.1052 - Payments from or to certain tax-exempt trusts or payments under or into certain annuity plans.

Code of Federal Regulations, 2013 CFR

2013-04-01

... SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Wages § 404.1052 Payments from or to certain tax-exempt...

20 CFR 404.1052 - Payments from or to certain tax-exempt trusts or payments under or into certain annuity plans.

Code of Federal Regulations, 2014 CFR

2014-04-01

... SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Wages § 404.1052 Payments from or to certain tax-exempt...

Payment policy and the growth of Medicare Advantage.

PubMed

Zarabozo, Carlos; Harrison, Scott

2009-01-01

This paper reviews recent trends in Medicare Advantage, examining program costs, access to plans, enrollment, plan bids, and benchmarks. We find that current policy has favored the growth of particular types of plans. Bid data show that plans are paid, on average, 113 percent of what expenditures would have been under the traditional Medicare program. Although some of the plan payments are used to finance extra benefits for enrollees, paying plans at higher than fee-for-service levels could affect the sustainability of the Medicare program and result in increased costs for all taxpayers and beneficiaries.

26 CFR 31.3121(a)(2)-1 - Payments on account of sickness or accident disability, medical or hospitalization expenses, or...

Code of Federal Regulations, 2011 CFR

2011-04-01

... employee or any of his dependents under a plan or system established by an employer which makes provision... of his dependents. (b) The plan or system established by an employer need not provide for payments on account of all of the specified items, but such plan or system may provide for any one or more of such...

26 CFR 31.3121(a)(2)-1 - Payments on account of sickness or accident disability, medical or hospitalization expenses, or...

Code of Federal Regulations, 2012 CFR

2012-04-01

... employee or any of his dependents under a plan or system established by an employer which makes provision... of his dependents. (b) The plan or system established by an employer need not provide for payments on account of all of the specified items, but such plan or system may provide for any one or more of such...

26 CFR 31.3121(a)(2)-1 - Payments on account of sickness or accident disability, medical or hospitalization expenses, or...

Code of Federal Regulations, 2013 CFR

2013-04-01

... employee or any of his dependents under a plan or system established by an employer which makes provision... of his dependents. (b) The plan or system established by an employer need not provide for payments on account of all of the specified items, but such plan or system may provide for any one or more of such...

26 CFR 31.3121(a)(2)-1 - Payments on account of sickness or accident disability, medical or hospitalization expenses, or...

Code of Federal Regulations, 2014 CFR

2014-04-01

... employee or any of his dependents under a plan or system established by an employer which makes provision... of his dependents. (b) The plan or system established by an employer need not provide for payments on account of all of the specified items, but such plan or system may provide for any one or more of such...

7 CFR 1403.4 - Demand for payment of debts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... payment interest rate set out in § 1403.9. (4) CCC's intent, if applicable, to collect the debt 30 days... for and the amount of the debt determined to be due CCC, including the principal, applicable interest...) The applicable late payment interest rate. (i) If a late payment interest rate is specified in the...

User-centric incentive design for participatory mobile phone sensing

NASA Astrophysics Data System (ADS)

Gao, Wei; Lu, Haoyang

2014-05-01

Mobile phone sensing is a critical underpinning of pervasive mobile computing, and is one of the key factors for improving people's quality of life in modern society via collective utilization of the on-board sensing capabilities of people's smartphones. The increasing demands for sensing services and ambient awareness in mobile environments highlight the necessity of active participation of individual mobile users in sensing tasks. User incentives for such participation have been continuously offered from an application-centric perspective, i.e., as payments from the sensing server, to compensate users' sensing costs. These payments, however, are manipulated to maximize the benefits of the sensing server, ignoring the runtime flexibility and benefits of participating users. This paper presents a novel framework of user-centric incentive design, and develops a universal sensing platform which translates heterogenous sensing tasks to a generic sensing plan specifying the task-independent requirements of sensing performance. We use this sensing plan as input to reduce three categories of sensing costs, which together cover the possible sources hindering users' participation in sensing.

75 FR 10289 - Notice of Opportunity for a Hearing on Compliance of Missouri State Plan Provisions Concerning...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... provisions concerning payments for home health services comply with the requirements of the Social Security... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Notice of Opportunity for a Hearing on Compliance of Missouri State Plan Provisions Concerning Payments for Home Health...

Effects of Escalating and Descending Schedules of Incentives on Cigarette Smoking in Smokers without Plans to Quit

ERIC Educational Resources Information Center

Romanowich, Paul; Lamb, R. J.

2010-01-01

Contingent incentives can reduce substance abuse. Escalating payment schedules, which begin with a small incentive magnitude and progressively increase with meeting the contingency, increase smoking abstinence. Likewise, descending payment schedules can increase cocaine abstinence. The current experiment enrolled smokers without plans to quit in…

75 FR 78877 - Employee Contribution Elections and Contribution Allocations; Uniformed Services Accounts...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... From the Thrift Savings Plan; Death Benefits; Thrift Savings Plan AGENCY: Federal Retirement Thrift... beneficiary of a TSP participant must either transfer his or her TSP death benefit payment to another eligible... allow a spouse of a deceased participant to retain a lump sum death benefit payment in the TSP. This...

45 CFR 234.11 - Assistance in the form of money payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Assistance in the form of money payments. 234.11... FINANCIAL ASSISTANCE TO INDIVIDUALS § 234.11 Assistance in the form of money payments. (a) Federal financial participation is available in money payments made under a State plan under title I, IV-A, X, XIV, or XVI of the...

45 CFR 234.11 - Assistance in the form of money payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Assistance in the form of money payments. 234.11... FINANCIAL ASSISTANCE TO INDIVIDUALS § 234.11 Assistance in the form of money payments. (a) Federal financial participation is available in money payments made under a State plan under title I, IV-A, X, XIV, or XVI of the...

45 CFR 234.11 - Assistance in the form of money payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Assistance in the form of money payments. 234.11... FINANCIAL ASSISTANCE TO INDIVIDUALS § 234.11 Assistance in the form of money payments. (a) Federal financial participation is available in money payments made under a State plan under title I, IV-A, X, XIV, or XVI of the...

7 CFR 792.4 - Demand for payment of debts.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., applicable interest, costs, and other charges; (2) FSA' intent to establish an account on a debt record 30... that time; (3) The applicable late payment interest rate. (i) If a late payment interest rate is... the date from which the late payment interest has been accruing; (ii) If a late payment interest rate...

7 CFR 1951.11 - Application of payments on real estate accounts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 14 2011-01-01 2011-01-01 false Application of payments on real estate accounts. 1951... Servicing Policies § 1951.11 Application of payments on real estate accounts. (a) Regular payments. If a borrower owes more than one type of real estate loan, or has received initial and subsequent real estate...

7 CFR 1951.11 - Application of payments on real estate accounts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Application of payments on real estate accounts. 1951... Servicing Policies § 1951.11 Application of payments on real estate accounts. (a) Regular payments. If a borrower owes more than one type of real estate loan, or has received initial and subsequent real estate...

7 CFR 1951.11 - Application of payments on real estate accounts.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 14 2012-01-01 2012-01-01 false Application of payments on real estate accounts. 1951... Servicing Policies § 1951.11 Application of payments on real estate accounts. (a) Regular payments. If a borrower owes more than one type of real estate loan, or has received initial and subsequent real estate...

7 CFR 1951.11 - Application of payments on real estate accounts.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 14 2013-01-01 2013-01-01 false Application of payments on real estate accounts. 1951... Servicing Policies § 1951.11 Application of payments on real estate accounts. (a) Regular payments. If a borrower owes more than one type of real estate loan, or has received initial and subsequent real estate...

7 CFR 1951.11 - Application of payments on real estate accounts.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 14 2014-01-01 2014-01-01 false Application of payments on real estate accounts. 1951... Servicing Policies § 1951.11 Application of payments on real estate accounts. (a) Regular payments. If a borrower owes more than one type of real estate loan, or has received initial and subsequent real estate...

Emerging Lessons From Regional and State Innovation in Value-Based Payment Reform: Balancing Collaboration and Disruptive Innovation

PubMed Central

Conrad, Douglas A; Grembowski, David; Hernandez, Susan E; Lau, Bernard; Marcus-Smith, Miriam

2014-01-01

Policy Points: Public and private purchasersmust create a "burning bridge" of countervailing pressure that signals "no turning back" to fee-for-service in order to sustain the momentum for value-based payment. Multi-stakeholder coalitions must establish a defined set of quality, outcomes, and cost performance measures and the interoperable information systems to support data collection and reporting of value-based payment schemes. Anti-trust vigilance is necessary to find the "sweet spot" of competition and cooperation among health plans and health care providers. Provider and health plan transparency of price and quality, supported by all-payer claims data, are critical in driving value-based payment innovation and cost constraint. Context In recent decades, practitioners and policymakers have turned to value-based payment initiatives to help contain spending on health care and to improve the quality of care. The Robert Wood Johnson Foundation funded 7 grantees across the country to design and implement value-based, multistakeholder payment reform projects in 6 states and 3 regions of the United States. Methods As the external evaluator of these projects, we reviewed documents, conducted Internet searches, interviewed key stakeholders, cross-validated factual and narrative interpretation, and performed qualitative analyses to derive cross-site themes and implications for policy and practice. Findings The nature of payment reform and its momentum closely reflects the environmental context of each project. Federal legislation such as the Patient Protection and Affordable Care Act and federal and state support for the development of the patient-centered medical home and accountable care organizations encourage value-based payment innovation, as do local market conditions for payers and providers that combine a history of collaboration with independent innovation and experimentation by individual organizations. Multistakeholder coalitions offer a useful facilitating structure for galvanizing payment reform. But to achieve the objectives of reduced cost and improved quality, multistakeholder payment innovation must overcome such barriers as incompatible information systems, the technical difficulties and transaction costs of altering existing billing and payment systems, competing stakeholder priorities, insufficient scale to bear population health risk, providers’ limited experience with risk-bearing payment models, and the failure to align care delivery models with the form of payment. Conclusions From the evidence adduced in this article, multistakeholder, value-based payment reform requires a trusted, widely respected “honest broker” that can convene and maintain the ongoing commitment of health plans, providers, and purchasers. Change management is complex and challenging, and coalition governance requires flexibility and stable leadership, as market conditions and stakeholder engagement and priorities shift over time. Another significant facilitator of value-based payment reform is outside investment that enables increased investment in human resources, information infrastructure, and care management by provider organizations and their collaborators. Supportive community and social service networks that enhance population health management also are important enablers of value-based payment reform. External pressure from public and private payers is fueling a “burning bridge” between the past of fee-for-service payment models and the future of payments based on value. Robust competition in local health plan and provider markets, coupled with an appropriate mix of multistakeholder governance, pressure from organized purchasers, and regulatory oversight, has the potential to spur value-based payment innovation that combines elements of “reformed” fee-for-service with bundled payments and global payments. PMID:25199900

Patient Protection and Affordable Care Act; third party payment of qualified health plan premiums. Interim final rule with comment period.

PubMed

2014-03-19

This interim final rule requires issuers of qualified health plans (QHPs), including stand-alone dental plans (SADPs), to accept premium and cost-sharing payments made on behalf of enrollees by the Ryan White HIV/AIDS Program, other Federal and State government programs that provide premium and cost sharing support for specific individuals, and Indian tribes, tribal organizations, and urban Indian organizations.

Competitive bidding in Medicare: who benefits from competition?

PubMed

Song, Zirui; Landrum, Mary Beth; Chernew, Michael E

2012-09-01

To conduct the first empirical study of competitive bidding in Medicare. We analyzed 2006-2010 Medicare Advantage data from the Centers for Medicare and Medicaid Services using longitudinal models adjusted for market and plan characteristics. A $1 increase in Medicare's payment to health maintenance organization (HMO) plans led to a $0.49 (P <.001) increase in plan bids, with $0.34 (P <.001) going to beneficiaries in the form of extra benefits or lower cost sharing. With preferred provider organization and private fee-for-service plans included, higher Medicare payments increased bids less ($0.33 per dollar), suggesting more competition among these latter plans. As a market-based alternative to cost control through administrative pricing, competitive bidding relies on private insurance plans proposing prices they are willing to accept for insuring a beneficiary. However, competition is imperfect in the Medicare bidding market. As much as half of every dollar in increased plan payment went to higher bids rather than to beneficiaries. While having more insurers in a market lowered bids, the design of any bidding system for Medicare should recognize this shortcoming of competition.

Smart Cards for Transit : Multi-Use Remotely Interrogated Stored-Data Cards for Fare and Toll Payment

DOT National Transportation Integrated Search

1995-04-01

This project developed relevant information on existing and future, stored readable/writable data card technology for fare and toll payments. The project supports the FTA objective of developing a plan for a common standard card-based fare payment sy...

12 CFR Appendix M1 to Part 226 - Repayment Disclosures

Code of Federal Regulations, 2014 CFR

2014-01-01

... a fixed period of time, as set forth by the card issuer. (2) “Deferred interest or similar plan... calculating the minimum payment repayment estimate, card issuers must use the minimum payment formula(s) that... purchases, such as a “club plan purchase.” Also, assume that based on a consumer's balances in these...

12 CFR Appendix M1 to Part 226 - Repayment Disclosures

Code of Federal Regulations, 2012 CFR

2012-01-01

... of time, as set forth by the card issuer. (2) “Deferred interest or similar plan” means a plan where... payment repayment estimate, card issuers must use the minimum payment formula(s) that apply to a..., such as a “club plan purchase.” Also, assume that based on a consumer's balances in these features and...

12 CFR Appendix M1 to Part 226 - Repayment Disclosures

Code of Federal Regulations, 2011 CFR

2011-01-01

... of time, as set forth by the card issuer. (2) “Deferred interest or similar plan” means a plan where... payment repayment estimate, card issuers must use the minimum payment formula(s) that apply to a..., such as a “club plan purchase.” Also, assume that based on a consumer's balances in these features and...

12 CFR Appendix M1 to Part 226 - Repayment Disclosures

Code of Federal Regulations, 2013 CFR

2013-01-01

... a fixed period of time, as set forth by the card issuer. (2) “Deferred interest or similar plan... calculating the minimum payment repayment estimate, card issuers must use the minimum payment formula(s) that... purchases, such as a “club plan purchase.” Also, assume that based on a consumer's balances in these...

42 CFR 413.88 - Incentive payments under plans for voluntary reduction in number of medical residents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... voluntary residency reduction plan. (5) Updates to annual and cumulative targets (i) Except as provided in... paragraphs (g)(2) and (g)(3) of this section. (ii) An entity may update annual reduction targets specified in... used for direct GME payments for the last residency training year in which a qualifying entity...

42 CFR 411.162 - Medicare benefits secondary to group health plan benefits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... entitled on the basis of age or disability), Medicare is secondary to any GHP (including a retirement plan... Medicare payments as follows: (i) Primary payments only for Medicare covered services that are— (A... have been entitled to Medicare as early as March 1, 1991, Medicare is secondary payer only from March 1...

29 CFR 825.212 - Employee failure to pay health plan premium payments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.212 Employee failure to pay health plan premium payments. (a)(1) In... unpaid leave that provide for the employer to cease coverage retroactively to the date the unpaid premium...

29 CFR 825.212 - Employee failure to pay health plan premium payments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.212 Employee failure to pay health plan premium payments. (a)(1) In... unpaid leave that provide for the employer to cease coverage retroactively to the date the unpaid premium...

29 CFR 825.212 - Employee failure to pay health plan premium payments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.212 Employee failure to pay health plan premium payments. (a)(1) In... unpaid leave that provide for the employer to cease coverage retroactively to the date the unpaid premium...

29 CFR 825.212 - Employee failure to pay health plan premium payments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.212 Employee failure to pay health plan premium payments. (a)(1) In... unpaid leave that provide for the employer to cease coverage retroactively to the date the unpaid premium...

5 CFR 575.513 - What are the agency's and the employee's obligations when an employee fails to fulfill the terms...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, RELOCATION, AND... and has received incentive payments whose value as a percentage of the planned total sum of incentive... paragraph (b) of this section and has received incentive payments whose value as a percentage of the planned...

7 CFR 1430.302 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS DAIRY PRODUCTS 2004 Dairy Disaster Assistance Payment... purposes of administering the 2004 Dairy Disaster Assistance Payment Program established by this subpart. Application means the 2004 Dairy Disaster Assistance Payment Program Application. Application period means the...

7 CFR 1430.302 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS DAIRY PRODUCTS 2004 Dairy Disaster Assistance Payment... purposes of administering the 2004 Dairy Disaster Assistance Payment Program established by this subpart. Application means the 2004 Dairy Disaster Assistance Payment Program Application. Application period means the...

7 CFR 1430.302 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS DAIRY PRODUCTS 2004 Dairy Disaster Assistance Payment... purposes of administering the 2004 Dairy Disaster Assistance Payment Program established by this subpart. Application means the 2004 Dairy Disaster Assistance Payment Program Application. Application period means the...

29 CFR 4007.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of this chapter: continuation plan, new plan, newly covered plan, participant, participant count, premium funding target, premium payment year short plan year, small plan, and UVB valuation date. [61 FR...

Impact of cost sharing on prescription drugs used by Medicare beneficiaries.

PubMed

Goedken, Amber M; Urmie, Julie M; Farris, Karen B; Doucette, William R

2010-06-01

Incentive-based prescription drug cost sharing can encourage seniors to use generic medications. Little information exists about prescription drug cost sharing and generic use in employer-sponsored plans after the implementation of Medicare Part D. To compare prescription drug cost sharing across prescription insurance type for Medicare beneficiaries after Medicare Part D, to assess the impact of that cost sharing on the number of medications used, and to examine how generic utilization rates differ before and after Medicare Part D and across the type of insurance. This longitudinal study of Medicare beneficiaries aged 65 years and older used Web-based surveys administered in 2005 and 2007 by Harris Interactive((R)) to collect information on prescription drug coverage and medication use. Co-payment plans were categorized as low, medium, or high co-payment plans. Multiple regression was used to assess the impact of co-payment rank on the number of prescription drugs. t-Tests and analysis of variance were used to compare generic use over time and between coverage types. One thousand two hundred twenty and 1024 respondents completed the baseline and follow-up surveys, respectively. Among 3-tier co-payment plans, brand drug co-payments were higher for Part D plans ($26 for preferred brand and $55 for nonpreferred brand) than employer-based plans ($20 for preferred brand and $39 for nonpreferred brand). Co-payment was not a significant predictor for the number of prescription drugs. Generic use was lowest among beneficiaries in employer plans both before and after Part D. In 2007, generic use among beneficiaries with Part D was not significantly different from the generic use for beneficiaries with no drug coverage. Medicare beneficiaries in Part D had higher cost sharing amounts than those with employer coverage, but higher cost sharing was not significantly linked to lower prescription use. Generic use for Part D beneficiaries was higher than that for beneficiaries with employer coverage but the same as that for beneficiaries without drug coverage. Copyright 2010 Elsevier Inc. All rights reserved.

7 CFR 1416.5 - Application for payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Application for payment. 1416.5 Section 1416.5... Application for payment. (a) A producer who applies for any program under subparts B through H of this part shall submit an application and required supporting documentation to the county FSA office serving the...

46 CFR 308.3 - Applications for insurance; warranties; supporting documents; payment of binder fees.

Code of Federal Regulations, 2012 CFR

2012-10-01

... documents; payment of binder fees. 308.3 Section 308.3 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE General § 308.3 Applications for insurance; warranties; supporting documents; payment of binder fees. (a) Application, binder forms. A single application for War...

46 CFR 308.3 - Applications for insurance; warranties; supporting documents; payment of binder fees.

Code of Federal Regulations, 2014 CFR

2014-10-01

... documents; payment of binder fees. 308.3 Section 308.3 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE General § 308.3 Applications for insurance; warranties; supporting documents; payment of binder fees. (a) Application, binder forms. A single application for War...

46 CFR 308.3 - Applications for insurance; warranties; supporting documents; payment of binder fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... documents; payment of binder fees. 308.3 Section 308.3 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE General § 308.3 Applications for insurance; warranties; supporting documents; payment of binder fees. (a) Application, binder forms. A single application for War...

46 CFR 308.3 - Applications for insurance; warranties; supporting documents; payment of binder fees.

Code of Federal Regulations, 2013 CFR

2013-10-01

... documents; payment of binder fees. 308.3 Section 308.3 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE General § 308.3 Applications for insurance; warranties; supporting documents; payment of binder fees. (a) Application, binder forms. A single application for War...

42 CFR § 414.1310 - Applicability.

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 § 414.1310 Applicability. (a) Program Implementation. Except as specified in paragraph (b) of this section, MIPS applies to payments for items and...

32 CFR 48.506 - Recovery of erroneous annuity payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Recovery of erroneous annuity payments. 48.506..., MILITARY AND CIVILIAN RETIRED SERVICEMAN'S FAMILY PROTECTION PLAN Annuity § 48.506 Recovery of erroneous annuity payments. (a) The Secretary of the Department concerned is empowered to use any means provided by...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2013 CFR

2013-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2012 CFR

2012-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2014 CFR

2014-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2010 CFR

2010-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2011 CFR

2011-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

An Economic History of Medicare Part C

PubMed Central

Mcguire, Thomas G; Newhouse, Joseph P; Sinaiko, Anna D

2011-01-01

Context: Twenty-five years ago, private insurance plans were introduced into the Medicare program with the stated dual aims of (1) giving beneficiaries a choice of health insurance plans beyond the fee-for-service Medicare program and (2) transferring to the Medicare program the efficiencies and cost savings achieved by managed care in the private sector. Methods: In this article we review the economic history of Medicare Part C, known today as Medicare Advantage, focusing on the impact of major changes in the program's structure and of plan payment methods on trends in the availability of private plans, plan enrollment, and Medicare spending. Additionally, we compare the experience of Medicare Advantage and of employer-sponsored health insurance with managed care over the same time period. Findings: Beneficiaries' access to private plans has been inconsistent over the program's history, with higher plan payments resulting in greater choice and enrollment and vice versa. But Medicare Advantage generally has cost more than the traditional Medicare program, an overpayment that has increased in recent years. Conclusions: Major changes in Medicare Advantage's payment rules are needed in order to simultaneously encourage the participation of private plans, the provision of high-quality care, and to save Medicare money. PMID:21676024

Effect of medicare payment on rural health care systems.

PubMed

McBride, Timothy D; Mueller, Keith J

2002-01-01

Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.

42 CFR 413.88 - Incentive payments under plans for voluntary reduction in number of medical residents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... reduction plan. (5) Updates to annual and cumulative targets (i) Except as provided in paragraph (g)(5)(ii...)(2) and (g)(3) of this section. (ii) An entity may update annual reduction targets specified in its... used for direct GME payments for the last residency training year in which a qualifying entity...

49 CFR 386.83 - Sanction for failure to pay civil penalties or abide by payment plan; operation in interstate...

Code of Federal Regulations, 2014 CFR

2014-10-01

... abide by payment plan; operation in interstate commerce prohibited. 386.83 Section 386.83 Transportation... commerce prohibited. (a)(1) General rule. (i) A CMV owner or operator that fails to pay a civil penalty in... from operating in interstate commerce starting on the next (i.e., the 91st) day. The prohibition...

Paying to Get Paid.

PubMed

Sorrel, Amy Lynn

2015-12-01

Some health plans and third-party vendors that process plan payments are moving to virtual credit cards, without warning and without much explanation of fees or opt-out procedures. Physician practices don't have to accept the financial and administrative costs associated with virtual cards. TMA officials say doctors have a choice and the right to demand that their payers issue payments via direct deposit.

25 CFR 171.555 - What additional costs will I incur if I am granted a Payment Plan?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false What additional costs will I incur if I am granted a... AND WATER IRRIGATION OPERATION AND MAINTENANCE Financial Matters: Assessments, Billing, and Collections § 171.555 What additional costs will I incur if I am granted a Payment Plan? You will incur the...

25 CFR 171.555 - What additional costs will I incur if I am granted a Payment Plan?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What additional costs will I incur if I am granted a... AND WATER IRRIGATION OPERATION AND MAINTENANCE Financial Matters: Assessments, Billing, and Collections § 171.555 What additional costs will I incur if I am granted a Payment Plan? You will incur the...

20 CFR 416.2060 - Mandatory minimum supplementary payments not applicable.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Mandatory minimum supplementary payments not applicable. 416.2060 Section 416.2060 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2060 Mandatory minimum supplementary payments not applicable. An individual eligible for mandatory...

20 CFR 416.2060 - Mandatory minimum supplementary payments not applicable.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Mandatory minimum supplementary payments not applicable. 416.2060 Section 416.2060 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2060 Mandatory minimum supplementary payments not applicable. An individual eligible for mandatory...

20 CFR 416.2060 - Mandatory minimum supplementary payments not applicable.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Mandatory minimum supplementary payments not applicable. 416.2060 Section 416.2060 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2060 Mandatory minimum supplementary payments not applicable. An individual eligible for mandatory...

20 CFR 416.2060 - Mandatory minimum supplementary payments not applicable.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Mandatory minimum supplementary payments not applicable. 416.2060 Section 416.2060 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2060 Mandatory minimum supplementary payments not applicable. An individual eligible for mandatory...

12 CFR Appendix M1 to Part 1026 - Repayment Disclosures

Code of Federal Regulations, 2012 CFR

2012-01-01

... terms of a cardholder's account that will expire in a fixed period of time, as set forth by the card... estimates. (1) Minimum payment formulas. When calculating the minimum payment repayment estimate, card... calculate the minimum payment amount for special purchases, such as a “club plan purchase.” Also, assume...

12 CFR Appendix M1 to Part 1026 - Repayment Disclosures

Code of Federal Regulations, 2013 CFR

2013-01-01

... terms of a cardholder's account that will expire in a fixed period of time, as set forth by the card... estimates. (1) Minimum payment formulas. When calculating the minimum payment repayment estimate, card... calculate the minimum payment amount for special purchases, such as a “club plan purchase.” Also, assume...

5 CFR 1651.14 - How payment is made.

Code of Federal Regulations, 2010 CFR

2010-01-01

... payment to a traditional IRA or eligible employer plan (including the spouse's TSP account, if he or she already has one). A transfer to a spouse's TSP account is permitted only if the spouse is not receiving monthly payments from the account. In order to request such a transfer, a spouse must use the transfer...

32 CFR 48.504 - Payment to children.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Payment to children. 48.504 Section 48.504... RETIRED SERVICEMAN'S FAMILY PROTECTION PLAN Annuity § 48.504 Payment to children. (a) Annuities for a child or children will be paid to the child's guardian, or if there is no guardian, to the person(s) who...

32 CFR 48.504 - Payment to children.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Payment to children. 48.504 Section 48.504... RETIRED SERVICEMAN'S FAMILY PROTECTION PLAN Annuity § 48.504 Payment to children. (a) Annuities for a child or children will be paid to the child's guardian, or if there is no guardian, to the person(s) who...

32 CFR 48.504 - Payment to children.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Payment to children. 48.504 Section 48.504... RETIRED SERVICEMAN'S FAMILY PROTECTION PLAN Annuity § 48.504 Payment to children. (a) Annuities for a child or children will be paid to the child's guardian, or if there is no guardian, to the person(s) who...

32 CFR 48.504 - Payment to children.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Payment to children. 48.504 Section 48.504... RETIRED SERVICEMAN'S FAMILY PROTECTION PLAN Annuity § 48.504 Payment to children. (a) Annuities for a child or children will be paid to the child's guardian, or if there is no guardian, to the person(s) who...

32 CFR 48.504 - Payment to children.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Payment to children. 48.504 Section 48.504... RETIRED SERVICEMAN'S FAMILY PROTECTION PLAN Annuity § 48.504 Payment to children. (a) Annuities for a child or children will be paid to the child's guardian, or if there is no guardian, to the person(s) who...

25 CFR 152.35 - Deferred payment sales.

Code of Federal Regulations, 2010 CFR

2010-04-01

... desire, a sale may be made or approved on the deferred payment plan. The terms of the sale will be... 25 Indians 1 2010-04-01 2010-04-01 false Deferred payment sales. 152.35 Section 152.35 Indians..., CERTIFICATES OF COMPETENCY, REMOVAL OF RESTRICTIONS, AND SALE OF CERTAIN INDIAN LANDS Mortgages and Deeds of...

Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017. Final rule.

PubMed

2016-03-08

This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional amendments regarding the annual open enrollment period for the individual market for the 2017 and 2018 benefit years; essential health benefits; cost sharing; qualified health plans; Exchange consumer assistance programs; network adequacy; patient safety; the Small Business Health Options Program; stand-alone dental plans; third-party payments to qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics.

Competitive Bidding in Medicare: Who Benefits From Competition?

PubMed Central

Song, Zirui; Landrum, Mary Beth; Chernew, Michael E.

2012-01-01

Objectives To conduct the first empirical study of competitive bidding in Medicare. Study Design and Methods We analyzed 2006–2010 Medicare Advantage data from the Centers for Medicare & Medicaid Services using longitudinal models adjusted for market and plan characteristics. Results A $1 increase in Medicare's payment to health maintenance organization (HMO) plans led to a $0.49 (P <.001) increase in plan bids, with $0.34 (P <.001) going to beneficiaries in the form of extra benefits or lower cost sharing. With preferred provider organization and private fee-for-service plans included, higher Medicare payments increased bids less ($0.33 per dollar), suggesting more competition among these latter plans. Conclusions As a market-based alternative to cost control through administrative pricing, competitive bidding relies on private insurance plans proposing prices they are willing to accept for insuring a beneficiary. However, competition is imperfect in the Medicare bidding market. As much as half of every dollar in increased plan payment went to higher bids rather than to beneficiaries. While having more insurers in a market lowered bids, the design of any bidding system for Medicare should recognize this shortcoming of competition. PMID:23009305

22 CFR 51.54 - Replacement passports without payment of applicable fees.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Replacement passports without payment of applicable fees. 51.54 Section 51.54 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.54 Replacement passports without payment of applicable fees. A passport issuing office...

22 CFR 51.54 - Replacement passports without payment of applicable fees.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Replacement passports without payment of applicable fees. 51.54 Section 51.54 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.54 Replacement passports without payment of applicable fees. A passport issuing office...

22 CFR 51.54 - Replacement passports without payment of applicable fees.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Replacement passports without payment of applicable fees. 51.54 Section 51.54 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.54 Replacement passports without payment of applicable fees. A passport issuing office...

22 CFR 51.54 - Replacement passports without payment of applicable fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Replacement passports without payment of applicable fees. 51.54 Section 51.54 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.54 Replacement passports without payment of applicable fees. A passport issuing office...

22 CFR 51.54 - Replacement passports without payment of applicable fees.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Replacement passports without payment of applicable fees. 51.54 Section 51.54 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.54 Replacement passports without payment of applicable fees. A passport issuing office...

7 CFR 760.8 - Application for payments for milk.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Application for payments for milk. 760.8 Section 760.8 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF... Farmers for Milk § 760.8 Application for payments for milk. The affected farmer or his legal...

7 CFR 760.8 - Application for payments for milk.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Application for payments for milk. 760.8 Section 760.8 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF... Farmers for Milk § 760.8 Application for payments for milk. The affected farmer or his legal...

7 CFR 760.8 - Application for payments for milk.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Application for payments for milk. 760.8 Section 760.8 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF... Farmers for Milk § 760.8 Application for payments for milk. The affected farmer or his legal...

25 CFR 87.10 - Per capita payment aspects of plans and protection of funds accruing to minors, legal...

Code of Federal Regulations, 2010 CFR

2010-04-01

... majority. (2) A private trust for the minors' per capita shares may be established subject to the approval... JUDGMENT FUNDS § 87.10 Per capita payment aspects of plans and protection of funds accruing to minors... incompetents shall be held in IIM accounts and administered pursuant to the provisions of § 115.5 of this...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

31 CFR 341.9 - Payment or redemption after death of owner.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Payment or redemption after death of... STATES RETIREMENT PLAN BONDS § 341.9 Payment or redemption after death of owner. (a) Order of precedence... at the time of his death. In any case coming under the provisions of this paragraph, a duly certified...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

Third Party Payments: Alternative Funding Sources for Drug Abuse Treatment Programs. Trainer's Manual and Trainee's Handbook.

ERIC Educational Resources Information Center

Priesman, Ira

This set of materials is designed to provide helping professionals with sufficient understanding of third-party payment systems so they are able to determine the feasibility of obtaining reimbursement for service, identify potential third-party payers, assess implications of introducing a third-party payments system, and develop a plan for…

31 CFR 341.9 - Payment or redemption after death of owner.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Payment or redemption after death of... STATES RETIREMENT PLAN BONDS § 341.9 Payment or redemption after death of owner. (a) Order of precedence... at the time of his death. In any case coming under the provisions of this paragraph, a duly certified...

31 CFR 341.9 - Payment or redemption after death of owner.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Payment or redemption after death of... STATES RETIREMENT PLAN BONDS § 341.9 Payment or redemption after death of owner. (a) Order of precedence... at the time of his death. In any case coming under the provisions of this paragraph, a duly certified...

27 CFR 28.131 - Application for return of wines withdrawn without payment of tax.

Code of Federal Regulations, 2010 CFR

2010-04-01

... wines withdrawn without payment of tax. 28.131 Section 28.131 Alcohol, Tobacco Products and Firearms... Withdrawal of Wine Without Payment of Tax for Exportation, Use on Vessels and Aircraft, Transfer to a Foreign... Return of Wines to Bonded Wine Cellar § 28.131 Application for return of wines withdrawn without payment...

5 CFR 1653.23 - Processing and payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCESSES AFFECTING THRIFT SAVINGS PLAN ACCOUNTS Child Abuse Court Orders § 1653.23 Processing and payment. To the maximum extent consistent with sections 8437(e)(3) and 8467(a)(2), child abuse court orders...

42 CFR 417.598 - Annual enrollment reconciliation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.598 Annual enrollment reconciliation. CMS... conducts this reconciliation as necessary to ensure that the payments made do not exceed or fall short of...

5 CFR 1653.23 - Processing and payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PROCESSES AFFECTING THRIFT SAVINGS PLAN ACCOUNTS Child Abuse Court Orders § 1653.23 Processing and payment. To the maximum extent consistent with sections 8437(e)(3) and 8467(a)(2), child abuse court orders...

5 CFR 1653.23 - Processing and payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PROCESSES AFFECTING THRIFT SAVINGS PLAN ACCOUNTS Child Abuse Court Orders § 1653.23 Processing and payment. To the maximum extent consistent with sections 8437(e)(3) and 8467(a)(2), child abuse court orders...

5 CFR 1653.23 - Processing and payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROCESSES AFFECTING THRIFT SAVINGS PLAN ACCOUNTS Child Abuse Court Orders § 1653.23 Processing and payment. To the maximum extent consistent with sections 8437(e)(3) and 8467(a)(2), child abuse court orders...

5 CFR 1653.23 - Processing and payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... PROCESSES AFFECTING THRIFT SAVINGS PLAN ACCOUNTS Child Abuse Court Orders § 1653.23 Processing and payment. To the maximum extent consistent with sections 8437(e)(3) and 8467(a)(2), child abuse court orders...

Regional payment systems partnership action plan : executive summary.

DOT National Transportation Integrated Search

2000-09-25

Advanced electronic payment system technologies are creating new business opportunities : for transportation service providers to partner and develop a truly seamless regional : transportation network for their customers. The ability to use a s...

42 CFR 447.321 - Outpatient hospital and clinic services: Application of upper payment limits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital and clinic services: Application of upper payment limits. 447.321 Section 447.321 Public Health CENTERS FOR MEDICARE & MEDICAID... Clinic Services § 447.321 Outpatient hospital and clinic services: Application of upper payment limits...

12 CFR 621.8 - Application of payments and income recognition on nonaccrual loans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Application of payments and income recognition... Application of payments and income recognition on nonaccrual loans. Each institution shall employ the... cash on such loan may qualify for recognition as interest income if all of the following...

12 CFR 621.8 - Application of payments and income recognition on nonaccrual loans.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Application of payments and income recognition... Application of payments and income recognition on nonaccrual loans. Each institution shall employ the... cash on such loan may qualify for recognition as interest income if all of the following...

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

48 CFR 225.7704-2 - Applicability of Balance of Payments Program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Applicability of Balance... in Support of Operations in Iraq or Afghanistan 225.7704-2 Applicability of Balance of Payments... it would be inconsistent with the public interest to apply the provisions of the Balance of Payments...

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

A nationwide survey of patient centered medical home demonstration projects.

PubMed

Bitton, Asaf; Martin, Carina; Landon, Bruce E

2010-06-01

The patient centered medical home has received considerable attention as a potential way to improve primary care quality and limit cost growth. Little information exists that systematically compares PCMH pilot projects across the country. Cross-sectional key-informant interviews. Leaders from existing PCMH demonstration projects with external payment reform. We used a semi-structured interview tool with the following domains: project history, organization and participants, practice requirements and selection process, medical home recognition, payment structure, practice transformation, and evaluation design. A total of 26 demonstrations in 18 states were interviewed. Current demonstrations include over 14,000 physicians caring for nearly 5 million patients. A majority of demonstrations are single payer, and most utilize a three component payment model (traditional fee for service, per person per month fixed payments, and bonus performance payments). The median incremental revenue per physician per year was $22,834 (range $720 to $91,146). Two major practice transformation models were identified--consultative and implementation of the chronic care model. A majority of demonstrations did not have well-developed evaluation plans. Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows.

A Standardized Relative Resource Cost Model for Medical Care: Application to Cancer Control Programs

PubMed Central

2013-01-01

Medicare data represent 75% of aged and permanently disabled Medicare beneficiaries enrolled in the fee-for-service (FFS) indemnity option, but the data omit 25% of beneficiaries enrolled in Medicare Advantage health maintenance organizations (HMOs). Little research has examined how longitudinal patterns of utilization differ between HMOs and FFS. The Burden of Cancer Study developed and implemented an algorithm to assign standardized relative costs to HMO and Medicare FFS data consistently across time and place. Medicare uses 15 payment systems to reimburse FFS providers for covered services. The standardized relative resource cost algorithm (SRRCA) adapts these various payment systems to utilization data. We describe the rationale for modifications to the Medicare payment systems and discuss the implications of these modifications. We applied the SRRCA to data from four HMO sites and the linked Surveillance, Epidemiology, and End Results–Medicare data. Some modifications to Medicare payment systems were required, because data elements needed to categorize utilization were missing from both data sources. For example, data were not available to create episodes for home health services received, so we assigned costs per visit based on visit type (nurse, therapist, and aide). For inpatient utilization, we modified Medicare’s payment algorithm by changing it from a flat payment per diagnosis-related group to daily rates for diagnosis-related groups to differentiate shorter versus longer stays. The SRRCA can be used in multiple managed care plans and across multiple FFS delivery systems within the United States to create consistent relative cost data for economic analyses. Prior to international use of the SRRCA, data need to be standardized. PMID:23962514

42 CFR 441.252 - State plan requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Sterilizations § 441.252 State plan requirements. A State plan must provide that the Medicaid agency will make payment under the plan for sterilization procedures and hysterectomies only if all the requirements of...

Payment policy and inefficient benefits in the Medicare+Choice program.

PubMed

Pizer, Steven D; Frakt, Austin B; Feldman, Roger

2003-06-01

We investigated whether constraints on premium rebates by health plans in the Medicare+Choice program result in inefficient benefits. Since relationships between revenue and benefits could be confounded by unobserved variation in the cost of coverage, we took advantage of natural experiment that occurred following passage of the Benefits Improvement and Protection Act of 2000. Our findings indicate that benefits in zero premium plans were more sensitive to changes in payment rates than were benefits in plans that charged nonzero premiums. These results strongly suggest that current Medicare policy induces plans to offer benefits that are not valued by enrollees at or above their cost.

Finance issue brief: prompt payment.

PubMed

Stauffer, M

1999-06-25

Although under standard business laws withholding prompt payment is considered an unfair trade practice, a number of states are enacting new laws or clarifying existing language to ensure that health plans are paying providers in a timely fashion.

Finance issue brief: prompt payment.

PubMed

Stauffer, M

1999-10-22

Although under standard business laws withholding prompt payment is considered an unfair trade practice, a number of states are enacting new laws or clarifying existing language to ensure that health plans are paying providers in a timely fashion.

14 CFR 152.505 - Termination for cause.

Code of Federal Regulations, 2010 CFR

2010-01-01

... additional obligations of grant funds. (d) Payments to be made to the sponsor or planning agency, or recoveries of payments by the FAA, under the grant shall be in accordance with the legal rights and...

14 CFR 152.505 - Termination for cause.

Code of Federal Regulations, 2011 CFR

2011-01-01

... additional obligations of grant funds. (d) Payments to be made to the sponsor or planning agency, or recoveries of payments by the FAA, under the grant shall be in accordance with the legal rights and...

14 CFR 152.505 - Termination for cause.

Code of Federal Regulations, 2014 CFR

2014-01-01

... additional obligations of grant funds. (d) Payments to be made to the sponsor or planning agency, or recoveries of payments by the FAA, under the grant shall be in accordance with the legal rights and...

14 CFR 152.505 - Termination for cause.

Code of Federal Regulations, 2013 CFR

2013-01-01

... additional obligations of grant funds. (d) Payments to be made to the sponsor or planning agency, or recoveries of payments by the FAA, under the grant shall be in accordance with the legal rights and...

14 CFR 152.505 - Termination for cause.

Code of Federal Regulations, 2012 CFR

2012-01-01

... additional obligations of grant funds. (d) Payments to be made to the sponsor or planning agency, or recoveries of payments by the FAA, under the grant shall be in accordance with the legal rights and...

25 CFR 290.10 - Is an Indian tribe in violation of IGRA if it makes per capita payments to its members from net...

Code of Federal Regulations, 2010 CFR

2010-04-01

... capita payments to its members from net gaming revenues without an approved tribal revenue allocation... capita payments to its members from net gaming revenues without an approved tribal revenue allocation... gaming revenues without an approved tribal revenue allocation plan. If you refuse to comply, the DOJ or...

26 CFR 1.1494-1 - Returns; payment and collection of tax.

Code of Federal Regulations, 2010 CFR

2010-04-01

... having as one of its principal purposes the avoidance of Federal income taxes. If the plan has been so... 26 Internal Revenue 12 2010-04-01 2010-04-01 false Returns; payment and collection of tax. 1.1494...) INCOME TAX (CONTINUED) INCOME TAXES Tax on Transfers to Avoid Income Tax § 1.1494-1 Returns; payment and...

26 CFR 1.7519-1T - Required payments for entities electing not to have required year (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... section 444 in effect (an “applicable election year”). (2) Returns and required payments. For each.... (3) Required payment. The term “required payment” means, with respect to any applicable election year... provided in paragraph (b)(1)(ii) of this section, the term “applicable percentage” means the percentage...

31 CFR 29.401 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... explains— (1) The procedures that participants and beneficiaries in the Judges Plan, Police and Firefighters Plan, and the Teachers Plan must follow in applying for Federal Benefit Payments; (2) The...

31 CFR 29.401 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... explains— (1) The procedures that participants and beneficiaries in the Judges Plan, Police and Firefighters Plan, and the Teachers Plan must follow in applying for Federal Benefit Payments; (2) The...

31 CFR 29.401 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... explains— (1) The procedures that participants and beneficiaries in the Judges Plan, Police and Firefighters Plan, and the Teachers Plan must follow in applying for Federal Benefit Payments; (2) The...

31 CFR 29.401 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... explains— (1) The procedures that participants and beneficiaries in the Judges Plan, Police and Firefighters Plan, and the Teachers Plan must follow in applying for Federal Benefit Payments; (2) The...

31 CFR 29.401 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... explains— (1) The procedures that participants and beneficiaries in the Judges Plan, Police and Firefighters Plan, and the Teachers Plan must follow in applying for Federal Benefit Payments; (2) The...

30 CFR 210.53 - When are my royalty reports and payments due?

Code of Federal Regulations, 2010 CFR

2010-07-01

... When are my royalty reports and payments due? (a) Completed Forms MMS-2014 for royalty payments and the...) Completed Forms MMS-2014 for rental payments, where applicable, and the associated payments are due as...

Medicare overpayments to private plans, 1985-2012: shifting seniors to private plans has already cost Medicare US$282.6 billion.

PubMed

Hellander, Ida; Himmelstein, David U; Woolhandler, Steffie

2013-01-01

Previous research has documented Medicare overpayments to the private Medicare Advantage (MA) plans that compete with traditional fee-for-service Medicare. This research has assessed individual categories of overpayment for, at most, a few years. However, no study has calculated the total overpayments to private plans since the program's inception. Prior to 2004, selective enrollment of healthier seniors was the major source of excess payments. We estimate this has added US$41 billion to Medicare's costs since 1985. Medicare adopted a risk-adjustment scheme in 2004, but this has not curbed private plans' ability to game the payment system. This has added US$122.5 billion to Medicare's costs since 2004. Congress mandated increased payment to private plans in the 2003 Medicare Modernization Act, which was mitigated, to a degree, by the subsequent Affordable Care Act. In total, we find that Medicare has overpaid private insurers by US$282.6 billion since 1985. Risk adjustment does not work in for-profit MA plans, which have a financial incentive, the data, and the ingenuity to game whatever system Medicare devises. It is time to end Medicare's costly experiment with privatization. The U.S. needs to adopt a single-payer national health insurance program with effective methods for controlling costs.

Use of business planning methods to monitor global health budgets in Turkmenistan.

PubMed Central

Ensor, T.; Amannyazova, B.

2000-01-01

After undergoing many changes, the financing of health care in countries of the former Soviet Union is now showing signs of maturing. Soon after the political transition in these countries, the development of insurance systems and fee-for-service payment systems dominated the discussions on health reform. At present there is increasing emphasis on case mix adjusted payments in larger hospitals and on global budgets in smaller district hospitals. The problem is that such systems are often mistrusted for not providing sufficient financial control. At the same time, unless further planned restructuring is introduced, payment systems cannot on their own induce the fundamental change required in the health care system. As described in this article, in Tejen etrap (district), Turkmenistan, prospective business plans, which link planned objectives and activities with financial allocations, provide a framework for setting and monitoring budget expenditure. Plans can be linked to the overall objectives of the restructuring system and can be used to ensure sound financial management. The process of business planning, which calls for a major change in the way health facilities examine their activities, can be used as a vehicle to increase awareness of management issues. It also provides a way of satisfying the requirement for a rigorous, bottom-up planning of financial resources. PMID:10994288

The Financial Impact of Advanced Kidney Disease on Canada Pension Plan and Private Disability Insurance Costs

PubMed Central

Manns, Braden; McKenzie, Susan Q.; Au, Flora; Gignac, Pamela M.; Geller, Lawrence Ian

2017-01-01

Background: Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown. Objective: The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs. Design: This study used an analytical model combining Canadian data from various sources. Setting and Patients: This study included all patients with advanced CKD in Canada, including those with estimated glomerular filtration rate (eGFR) <30 mL/min/m2 and those on dialysis. Measurements: We combined disability estimates from a provincial kidney care program with the prevalence of advanced CKD and estimated disability payments from the Canada Pension Plan and private insurance plans to estimate overall disability benefit payments for Canadians with advanced CKD. Results: We estimate that Canadians with advanced kidney failure are receiving disability benefit payments of at least Can$217 million annually. These estimates are sensitive to the proportion of individuals with advanced kidney disease who are unable to work, and plausible variation in this estimate could mean patients with advanced kidney disease are receiving up to Can$260 million per year. Feasible strategies to reduce the proportion of individuals with advanced kidney disease, either through prevention, delay or reduction in severity, or increasing the rate of transplantation, could result in reductions in the cost of Canada Pension Plan and private disability insurance payments by Can$13.8 million per year within 5 years. Limitations: This study does not estimate how CKD prevention or increasing the rate of kidney transplantation might influence health care cost savings more broadly, and does not include the cost to provincial governments for programs that provide income for individuals without private insurance and who do not qualify for Canada Pension Plan disability payments. Conclusions: Private disability insurance providers and federal government programs incur high costs related to individuals with advanced kidney failure, highlighting the significance of kidney disease not only to patients, and their families, but also to these other important stakeholders. Improvements in care of individuals with kidney disease could reduce these costs. PMID:28491340

The Financial Impact of Advanced Kidney Disease on Canada Pension Plan and Private Disability Insurance Costs.

PubMed

Manns, Braden; McKenzie, Susan Q; Au, Flora; Gignac, Pamela M; Geller, Lawrence Ian

2017-01-01

Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown. The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs. This study used an analytical model combining Canadian data from various sources. This study included all patients with advanced CKD in Canada, including those with estimated glomerular filtration rate (eGFR) <30 mL/min/m 2 and those on dialysis. We combined disability estimates from a provincial kidney care program with the prevalence of advanced CKD and estimated disability payments from the Canada Pension Plan and private insurance plans to estimate overall disability benefit payments for Canadians with advanced CKD. We estimate that Canadians with advanced kidney failure are receiving disability benefit payments of at least Can$217 million annually. These estimates are sensitive to the proportion of individuals with advanced kidney disease who are unable to work, and plausible variation in this estimate could mean patients with advanced kidney disease are receiving up to Can$260 million per year. Feasible strategies to reduce the proportion of individuals with advanced kidney disease, either through prevention, delay or reduction in severity, or increasing the rate of transplantation, could result in reductions in the cost of Canada Pension Plan and private disability insurance payments by Can$13.8 million per year within 5 years. This study does not estimate how CKD prevention or increasing the rate of kidney transplantation might influence health care cost savings more broadly, and does not include the cost to provincial governments for programs that provide income for individuals without private insurance and who do not qualify for Canada Pension Plan disability payments. Private disability insurance providers and federal government programs incur high costs related to individuals with advanced kidney failure, highlighting the significance of kidney disease not only to patients, and their families, but also to these other important stakeholders. Improvements in care of individuals with kidney disease could reduce these costs.

Regional Payment Systems Partnership action plan

DOT National Transportation Integrated Search

2000-09-25

Development of an integrated regional payment infrastructure for the Washington, D.C. area will be a complex undertaking. Nevertheless the benefits of creating a seamless transportation system, the initial success of Smart Tag and SmarTrip and the bu...

7 CFR 4288.130 - Payment applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... process and procedures the Agency will use to make payments to eligible advanced biofuel producers. In order to receive payments under this Program, eligible advanced biofuel producers with valid contracts...

7 CFR 4288.130 - Payment applications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... process and procedures the Agency will use to make payments to eligible advanced biofuel producers. In order to receive payments under this Program, eligible advanced biofuel producers with valid contracts...

7 CFR 4288.130 - Payment applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... identify the process and procedures the Agency will use to make payments to eligible advanced biofuel producers. In order to receive payments under this Program, eligible advanced biofuel producers with valid...

Having it all: national benefit equity and local payment parity in Medicare.

PubMed

Dowd, Bryan; Feldman, Roger

2002-01-01

The Medicare Payment Advisory Commission (MedPAC) has identified two important problems with the Medicare+Choice (M+C) program: nationwide geographic inequity in government-financed benefits, and unequal government payments for M+C plans versus fee-for-service (FFS) Medicare in the same market area. MedPAC concludes that both problems cannot be solved simultaneously. We argue that both problems could be solved if Congress discontinued its policy of underwriting the cost of FFS Medicare. Instead, Congress should define a national entitlement benefit package and have all health plans submit bids on the package in each market area. The government's premium contribution should be equal to the lowest bid submitted by a qualified health plan in each market area. The contribution could be adjusted for health risk, the special obligations of FFS Medicare, and welfare enhancements associated with FFS Medicare that are valued by both beneficiaries and taxpayers but unrelated to beneficiaries' health status.

Launching a medicare advantage plan: smart planning saves headaches.

PubMed

Abrams, Robert J; Mullaney, Teri L

2007-11-01

If you're considering setting up a Medicare Advantage plan, the following are important considerations: Financial analysis. Payment rates. Medical costs. Marketing and operational costs. Technology infrastructure. Staffing.

24 CFR 242.30 - Application of payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... insurance; (b) Ground rents, taxes, special assessments, and fire and other hazard insurance premiums; (c... URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Mortgage Requirements § 242.30 Application of payments. All payments to be...

Paying Medicare Advantage plans by competitive bidding: how much competition is there?

PubMed

Biles, Brian; Pozen, Jonah; Guterman, Stuart

2009-08-01

Private health plans that enroll Medicare beneficiaries--known as Medicare Advantage (MA) plans--are being paid $11 billion more in 2009 than it would cost to cover these beneficiaries in regular fee-for-service Medicare. To generate Medicare savings for offsetting the costs of health reform, the Obama Administration has proposed eliminating these extra payments to private insurers and instituting a competitive bidding system that pays MA plans based on the bids they submit. This study examines the concentration of enrollment among MA plans and the degree to which firms offering MA plans actually face competition. The results show that in the large majority of U.S. counties, MA plan enrollment is highly concentrated in a small number of firms. Given the relative lack of competition in many markets as well as the potential impact on traditional Medicare, the authors call for careful consideration of a new system for setting MA plan payments.

12 CFR Appendix F to Part 226 - Annual Percentage Rate Computations for Certain Open-End Credit Plans

Code of Federal Regulations, 2010 CFR

2010-01-01

... adjusted balance (previous balance less payments and credits) and the consumer made a payment of $50 at the... convenience of the user, the revised text is set forth as follows: Pt. 226, App. F, Nt. Appendix F to Part 226... rate applies only to an adjusted balance (previous balance less payments and credits) and the consumer...

29 CFR Appendix B to Part 4050 - Examples of Benefit Payments for Missing Participants Under §§ 4050.8 Through 4050.10

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 9 2014-07-01 2014-07-01 false Examples of Benefit Payments for Missing Participants Under...) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS Pt. 4050, App. B Appendix B to Part 4050—Examples of Benefit Payments for Missing Participants Under §§ 4050.8 Through 4050.10 The...

29 CFR Appendix B to Part 4050 - Examples of Benefit Payments for Missing Participants Under §§ 4050.8 Through 4050.10

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 9 2011-07-01 2011-07-01 false Examples of Benefit Payments for Missing Participants Under...) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS Pt. 4050, App. B Appendix B to Part 4050—Examples of Benefit Payments for Missing Participants Under §§ 4050.8 Through 4050.10 The...

29 CFR Appendix B to Part 4050 - Examples of Benefit Payments for Missing Participants Under §§ 4050.8 Through 4050.10

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 9 2012-07-01 2012-07-01 false Examples of Benefit Payments for Missing Participants Under...) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS Pt. 4050, App. B Appendix B to Part 4050—Examples of Benefit Payments for Missing Participants Under §§ 4050.8 Through 4050.10 The...

29 CFR Appendix B to Part 4050 - Examples of Benefit Payments for Missing Participants Under §§ 4050.8 Through 4050.10

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false Examples of Benefit Payments for Missing Participants Under...) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS Pt. 4050, App. B Appendix B to Part 4050—Examples of Benefit Payments for Missing Participants Under §§ 4050.8 Through 4050.10 The...

45 CFR 95.505 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Cost Allocation Plans § 95.505... State agency except expenditures for financial assistance, medical vendor payments, and payments for...

Notification: Audit of CSB's Compliance With Improper Payment Legislation

EPA Pesticide Factsheets

November 17, 2015. The Environmental Protection Agency’s Office of Inspector General (OIG) for the U.S. Chemical Safety and Hazard Investigation Board (CSB) plans to begin its audit of CSB’s compliance with the improper payments legislation.

12 CFR 225.8 - Capital planning.

Code of Federal Regulations, 2014 CFR

2014-01-01

... instrument, a payment of common or preferred stock dividends, a payment that may be temporarily or... qualitative guidelines for dividend and stock repurchases; the strategies for addressing potential capital... 1 capital, including perpetual preferred stock and related surplus, minority interest in...

Regional Payment Systems Partnership action plan : executive summary

DOT National Transportation Integrated Search

2000-09-25

Development of an integrated regional payment infrastructure for the Washington, D.C. area will be a complex undertaking. Nevertheless the benefits of creating a seamless transportation system, the initial success of Smart Tag and SmarTrip and the bu...

48 CFR 8.709 - Payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Payments. 8.709 Section 8.709 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Nonprofit Agencies Employing People Who Are...

7 CFR 80.1 - Applicability and payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROGRAMS FRESH RUSSET POTATO DIVERSION PROGRAM Fresh Russet Potato Diversion Program § 80.1 Applicability and payments. Payment be received or retained with respect to diversions of 2001 Fresh Russet potatoes... producers or other persons under this part based upon their diversion of potatoes, shall be allowed except...

48 CFR 32.408 - Application for advance payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... amount of advance payments. (4) The name and address of the financial institution at which the contractor... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Application for advance... GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Advance Payments for Non-Commercial Items 32.408...

7 CFR 80.1 - Applicability and payments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... PROGRAMS FRESH RUSSET POTATO DIVERSION PROGRAM Fresh Russet Potato Diversion Program § 80.1 Applicability and payments. Payment be received or retained with respect to diversions of 2001 Fresh Russet potatoes... producers or other persons under this part based upon their diversion of potatoes, shall be allowed except...

7 CFR 80.1 - Applicability and payments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PROGRAMS FRESH RUSSET POTATO DIVERSION PROGRAM Fresh Russet Potato Diversion Program § 80.1 Applicability and payments. Payment be received or retained with respect to diversions of 2001 Fresh Russet potatoes... producers or other persons under this part based upon their diversion of potatoes, shall be allowed except...

7 CFR 80.1 - Applicability and payments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROGRAMS FRESH RUSSET POTATO DIVERSION PROGRAM Fresh Russet Potato Diversion Program § 80.1 Applicability and payments. Payment be received or retained with respect to diversions of 2001 Fresh Russet potatoes... producers or other persons under this part based upon their diversion of potatoes, shall be allowed except...

7 CFR 80.1 - Applicability and payments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PROGRAMS FRESH RUSSET POTATO DIVERSION PROGRAM Fresh Russet Potato Diversion Program § 80.1 Applicability and payments. Payment be received or retained with respect to diversions of 2001 Fresh Russet potatoes... producers or other persons under this part based upon their diversion of potatoes, shall be allowed except...

Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2018; Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program. Final rule.

PubMed

2016-12-22

This final rule sets forth payment parameters and provisions related to the risk adjustment program; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges and State-based Exchanges on the Federal platform. It also provides additional guidance relating to standardized options; qualified health plans; consumer assistance tools; network adequacy; the Small Business Health Options Programs; stand-alone dental plans; fair health insurance premiums; guaranteed availability and guaranteed renewability; the medical loss ratio program; eligibility and enrollment; appeals; consumer-operated and oriented plans; special enrollment periods; and other related topics.

Risk adjustment alternatives in paying for behavioral health care under Medicaid.

PubMed Central

Ettner, S L; Frank, R G; McGuire, T G; Hermann, R C

2001-01-01

OBJECTIVE: To compare the performance of various risk adjustment models in behavioral health applications such as setting mental health and substance abuse (MH/SA) capitation payments or overall capitation payments for populations including MH/SA users. DATA SOURCES/STUDY DESIGN: The 1991-93 administrative data from the Michigan Medicaid program were used. We compared mean absolute prediction error for several risk adjustment models and simulated the profits and losses that behavioral health care carve outs and integrated health plans would experience under risk adjustment if they enrolled beneficiaries with a history of MH/SA problems. Models included basic demographic adjustment, Adjusted Diagnostic Groups, Hierarchical Condition Categories, and specifications designed for behavioral health. PRINCIPAL FINDINGS: Differences in predictive ability among risk adjustment models were small and generally insignificant. Specifications based on relatively few MH/SA diagnostic categories did as well as or better than models controlling for additional variables such as medical diagnoses at predicting MH/SA expenditures among adults. Simulation analyses revealed that among both adults and minors considerable scope remained for behavioral health care carve outs to make profits or losses after risk adjustment based on differential enrollment of severely ill patients. Similarly, integrated health plans have strong financial incentives to avoid MH/SA users even after adjustment. CONCLUSIONS: Current risk adjustment methodologies do not eliminate the financial incentives for integrated health plans and behavioral health care carve-out plans to avoid high-utilizing patients with psychiatric disorders. PMID:11508640

42 CFR 416.167 - Basis of payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... classification (APC) groups and payment weights. (1) ASC covered surgical procedures are classified using the APC... section, an ASC relative payment weight is determined based on the APC relative payment weight for each covered surgical procedure and covered ancillary service that has an applicable APC relative payment...

76 FR 53137 - Bundled Payments for Care Improvement Initiative: Request for Applications

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... (RFA) will test episode-based payment for acute care and associated post-acute care, using both retrospective and prospective bundled payment methods. The RFA requests applications to test models centered around acute care; these models will inform the design of future models, including care improvement for...

26 CFR 1.707-4 - Disguised sales of property to partnership; special rules applicable to guaranteed payments...

Code of Federal Regulations, 2013 CFR

2013-04-01

...; special rules applicable to guaranteed payments, preferred returns, operating cash flow distributions, and... payments, preferred returns, operating cash flow distributions, and reimbursements of preformation... distribution of partnership cash flow to a partner with respect to capital contributed to the partnership by...

26 CFR 1.707-4 - Disguised sales of property to partnership; special rules applicable to guaranteed payments...

Code of Federal Regulations, 2012 CFR

2012-04-01

...; special rules applicable to guaranteed payments, preferred returns, operating cash flow distributions, and... payments, preferred returns, operating cash flow distributions, and reimbursements of preformation... distribution of partnership cash flow to a partner with respect to capital contributed to the partnership by...

26 CFR 1.707-4 - Disguised sales of property to partnership; special rules applicable to guaranteed payments...

Code of Federal Regulations, 2011 CFR

2011-04-01

...; special rules applicable to guaranteed payments, preferred returns, operating cash flow distributions, and... payments, preferred returns, operating cash flow distributions, and reimbursements of preformation... distribution of partnership cash flow to a partner with respect to capital contributed to the partnership by...

26 CFR 1.707-4 - Disguised sales of property to partnership; special rules applicable to guaranteed payments...

Code of Federal Regulations, 2014 CFR

2014-04-01

...; special rules applicable to guaranteed payments, preferred returns, operating cash flow distributions, and... payments, preferred returns, operating cash flow distributions, and reimbursements of preformation... distribution of partnership cash flow to a partner with respect to capital contributed to the partnership by...

26 CFR 31.3306(b)(10)-1 - Payments under certain employers' plans after retirement, disability, or death.

Code of Federal Regulations, 2010 CFR

2010-04-01

... example, lump-sum payments for unused vacation time or a final paycheck received after retirement are... within a reasonable time after the termination of an employee's employment relationship because of the...

26 CFR 31.3306(b)(10)-1 - Payments under certain employers' plans after retirement, disability, or death.

Code of Federal Regulations, 2011 CFR

2011-04-01

... example, lump-sum payments for unused vacation time or a final paycheck received after retirement are... within a reasonable time after the termination of an employee's employment relationship because of the...

12 CFR 225.8 - Capital planning.

Code of Federal Regulations, 2013 CFR

2013-01-01

... instrument, a payment of common or preferred stock dividends, a payment that may be temporarily or... stock repurchases; the strategies for addressing potential capital shortfalls; and the internal...-common elements of tier 1 capital, including perpetual preferred stock and related surplus, minority...

How to benefit from the coming RBRVS changes.

PubMed

Doherty, R B; Ogrod, E S

1989-09-01

The Physician Payment Review Commission's endorsement of the Resource-Based Relative Value Scale (RBRVS) represents a major step in reform of the Medicare payment system. Under this plan, cognitive services finally would be reimbursed at the same level for the work involved. The authors present a closer look at the commission's recommendations and discuss how these might substantially improve payment of primary care physicians. They also describe how to get ready.

76 FR 7935 - Advanced Biofuel Payment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

...The Rural Business-Cooperative Service (Agency) is establishing the Advanced Biofuel Payment Program authorized under the Food, Conservation, and Energy Act of 2008. Under this Program, the Agency will enter into contracts with advanced biofuel producers to pay such producers for the production of eligible advanced biofuels. To be eligible for payments, advanced biofuels must be produced from renewable biomass, excluding corn kernel starch, in a biofuel facility located in a State. In addition, this interim rule establishes new program requirements for applicants to submit applications for Fiscal Year 2010 payments for the Advanced Biofuel Payment Program. These new program requirements supersede the Notice of Contract Proposal (NOCP) for Payments to Eligible Advanced Biofuel Producers in its entirety.

Bundled payment fails to gain a foothold In California: the experience of the IHA bundled payment demonstration.

PubMed

Ridgely, M Susan; de Vries, David; Bozic, Kevin J; Hussey, Peter S

2014-08-01

To determine whether bundled payment could be an effective payment model for California, the Integrated Healthcare Association convened a group of stakeholders (health plans, hospitals, ambulatory surgery centers, physician organizations, and vendors) to develop, through a consensus process, the methods and means of implementing bundled payment. In spite of a high level of enthusiasm and effort, the pilot did not succeed in its goal to implement bundled payment for orthopedic procedures across multiple payers and hospital-physician partners. An evaluation of the pilot documented a number of barriers, such as administrative burden, state regulatory uncertainty, and disagreements about bundle definition and assumption of risk. Ultimately, few contracts were signed, which resulted in insufficient volume to test hypotheses about the impact of bundled payment on quality and costs. Although bundled payment failed to gain a foothold in California, the evaluation provides lessons for future bundled payment initiatives. Project HOPE—The People-to-People Health Foundation, Inc.

Costs, payments, and incentives in family planning programs: a review for developing countries.

PubMed

Ross, J A; Isaacs, S L

1988-01-01

Anxieties about financing health and family planning programs have grown in recent years, leading to discussions of cost-recovery measures that would raise charges to the consumer. Yet some governments wish to lower cost to encourage contraceptive use, and a few use incentives and disincentives. Data from numerous developing countries are presented on contraceptive cost topics: charges for contraceptive supplies and services, in both public and private sectors, and conversely, payments made to clients and providers to offset costs and to increase contraceptive use. The data show great diversity, and much inconsistency within countries, indicating that the structures of charges, payments, and incentives in many programs could be improved. Ethical considerations are discussed, and guidelines are suggested for developing effective financial policies.

12 CFR 625.29 - Payment of award.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FCA will pay the amount awarded to the applicant within 60 days of receipt of the applicant's... EXPENSES UNDER THE EQUAL ACCESS TO JUSTICE ACT Procedures for Considering Applications § 625.29 Payment of...

42 CFR 457.628 - Other applicable Federal regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Payments to States § 457.628 Other applicable Federal regulations. Other regulations applicable to CHIP... this chapter (Retention of payments) apply to States' CHIP programs in the same manner as they apply to...

20 CFR 404.780 - Evidence of “good cause” for exceeding time limits on accepting proof of support or application...

Code of Federal Regulations, 2010 CFR

2010-04-01

... accepting proof of support or application for a lump-sum death payment. (a) When evidence of good cause is... death payment. You may be asked for evidence of good cause for these delays if— (1) You are the insured... limits on accepting proof of support or application for a lump-sum death payment. 404.780 Section 404.780...

The Application of an Army Prospective Payment Model Structured on the Standards Set Forth by the CHAMPUS Maximum Allowable Charges and the Center for Medicare and Medicaid Services: An Academic Approach

DTIC Science & Technology

2005-04-29

To) 29-04-2005 Final Report July 2004 to July 2005 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER The appli’eation of an army prospective payment model structured...Z39.18 Prospective Payment Model 1 The Application of an Army Prospective Payment Model Structured on the Standards Set Forth by the CHAMPUS Maximum...Health Care Administration 20060315 090 Prospective Payment Model 2 Acknowledgments I would like to acknowledge my wife, Karen, who allowed me the

5 CFR 1653.15 - Payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Payment. 1653.15 Section 1653.15 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD COURT ORDERS AND LEGAL PROCESSES AFFECTING THRIFT SAVINGS PLAN ACCOUNTS Legal Process for the Enforcement of a Participant's Legal Obligations To...

45 CFR 156.1215 - Payment and collections processes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 156.1215 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Qualified Health Plan Issuer Responsibilities § 156.1215 Payment and collections...

20 CFR 416.2010 - Essentials of the administration agreements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... payments are made to all individuals and/or couples who are: (1) Receiving (or at the option of the State... assistance in the form of money payments under a plan of such State approved under title I, X, XIV, or XVI of...

20 CFR 302.4 - Nonqualifying earnings or payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 302.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT... organization; (b) Tips; (c) Payments under nongovernmental plans for unemployment, maternity or sickness... lost; (e) Wages from employment that is subject to the Federal Unemployment Tax Act; (f) Earnings from...

20 CFR 302.4 - Nonqualifying earnings or payments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Section 302.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT... organization; (b) Tips; (c) Payments under nongovernmental plans for unemployment, maternity or sickness... lost; (e) Wages from employment that is subject to the Federal Unemployment Tax Act; (f) Earnings from...

20 CFR 302.4 - Nonqualifying earnings or payments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Section 302.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT... organization; (b) Tips; (c) Payments under nongovernmental plans for unemployment, maternity or sickness... lost; (e) Wages from employment that is subject to the Federal Unemployment Tax Act; (f) Earnings from...

20 CFR 302.4 - Nonqualifying earnings or payments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Section 302.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT... organization; (b) Tips; (c) Payments under nongovernmental plans for unemployment, maternity or sickness... lost; (e) Wages from employment that is subject to the Federal Unemployment Tax Act; (f) Earnings from...

20 CFR 302.4 - Nonqualifying earnings or payments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Section 302.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT... organization; (b) Tips; (c) Payments under nongovernmental plans for unemployment, maternity or sickness... lost; (e) Wages from employment that is subject to the Federal Unemployment Tax Act; (f) Earnings from...

7 CFR 1450.213 - Levels and rates for establishment payments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... establishing non-woody perennial crops and woody perennial crops specified in the conservation plan, forest stewardship plan, or equivalent plan. (b) The average cost of performing a practice may be determined by CCC...

77 FR 52703 - Notice of Submission for OMB Review; Federal Student Aid; Electronic Debit Payment Option for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... the bank account information needed by ED to debit the applicant's account. The authority for the PDA... Payment Option for Student Loans SUMMARY: The Preauthorized Debit Account (PDA) Application is used to... debt payments debited from their bank accounts. DATES: Interested persons are invited to submit...

77 FR 52319 - Notice of Submission for OMB Review; Federal Student Aid; Electronic Debit Payment Option for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... the bank account information needed by ED to debit the applicant's account. The authority for the PDA... Payment Option for Student Loans SUMMARY: The Preauthorized Debit Account (PDA) Application is used to... debt payments debited from their bank accounts. DATES: Interested persons are invited to submit...

38 CFR 11.129 - Form of application for payment of deceased veteran's certificate.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As Amended (pub. L... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Form of application for payment of deceased veteran's certificate. 11.129 Section 11.129 Pensions, Bonuses, and Veterans' Relief...

38 CFR 11.129 - Form of application for payment of deceased veteran's certificate.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As Amended (pub. L... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Form of application for payment of deceased veteran's certificate. 11.129 Section 11.129 Pensions, Bonuses, and Veterans' Relief...

38 CFR 11.129 - Form of application for payment of deceased veteran's certificate.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As Amended (pub. L... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Form of application for payment of deceased veteran's certificate. 11.129 Section 11.129 Pensions, Bonuses, and Veterans' Relief...

38 CFR 11.129 - Form of application for payment of deceased veteran's certificate.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As Amended (pub. L... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Form of application for payment of deceased veteran's certificate. 11.129 Section 11.129 Pensions, Bonuses, and Veterans' Relief...

38 CFR 11.129 - Form of application for payment of deceased veteran's certificate.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As Amended (pub. L... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Form of application for payment of deceased veteran's certificate. 11.129 Section 11.129 Pensions, Bonuses, and Veterans' Relief...

26 CFR 1.7519-2T - Required payments-procedures and administration (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... payment under section 7519 for an applicable election year, the partnership or S corporation should type... termination of the section 444 election. (d) Negligence and fraud penalties made applicable. For purposes of section 6653, relating to additions to tax for negligence and fraud, any payment required by this section...

12 CFR 535.4 - Late charges.

Code of Federal Regulations, 2010 CFR

2010-01-01

... delinquency charge on a payment, which payment is otherwise a full payment for the applicable period and is paid on its due date or within an applicable grace period, when the only delinquency is attributable to late fee(s) or delinquency charge(s) assessed on earlier installment(s). (b) For the purposes of this...

Patient care delivery and integration: stimulating advancement of ambulatory care pharmacy practice in an era of healthcare reform.

PubMed

Epplen, Kelly T

2014-08-15

This article discusses how to plan and implement an ambulatory care pharmacist service, how to integrate a hospital- or health-system-based service with the mission and operations of the institution, and how to help the institution meet its challenges related to quality improvement, continuity of care, and financial sustainability. The steps in implementing an ambulatory care pharmacist service include (1) conducting a needs assessment, (2) aligning plans for the service with the mission and goals of the parent institution, (3) collaborating with patients and physicians, (4) standardizing the patient care process, (5) proposing the service, (6) attaining the necessary resources, (7) identifying stakeholders, (8) identifying applicable quality standards, (9) defining competency standards, (10) planning for service payment, and (11) monitoring outcomes. Ambulatory care pharmacists have current opportunities to become engaged with patient-centered medical homes, accountable care organizations, preventive and wellness programs, and continuity of care initiatives. Common barriers to the advancement of ambulatory care pharmacist services include lack of complete access to patient information, inadequate information technology, and lack of payment. Ambulatory care pharmacy practitioners must assertively promote appropriate medication use, provide patient-centered care, pursue integration with the patient care team, and seek appropriate recognition and compensation for the services they provide. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

78 FR 34380 - Agency Information Collection Activities; Proposals Submissions, and Approvals

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

... application reduces user confusion and wasted effort. The application allows for payment by credit card. The... application allows for payment by credit card. Affected Public: This form affects entities involved in the...

42 CFR 457.628 - Other applicable Federal regulations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Payments to States § 457.628 Other applicable Federal regulations. Other regulations applicable to CHIP... § 447.207 of this chapter (Retention of Payments) apply to State's CHIP programs in the same manner as...

Surgical Procedures in Health Professional Shortage Areas: Impact of a Surgical Incentive Payment Plan.

PubMed

Diaz, Adrian; Merath, Katiuscha; Bagante, Fabio; Chen, Qinyu; Akgul, Ozgur; Beal, Eliza; Idrees, Jay; Olsen, Griffin; Gani, Faiz; Pawlik, Timothy M

2018-05-15

The Affordable Care Act established a Center for Medicare/Medicaid Services based 10% reimbursement bonus for general surgeons in Health Professional Shortage Areas. We sought to assess the impact of the Affordable Care Act Surgery Incentive Payment on surgical procedures performed in Health Professional Shortage Areas. Hospital utilization data from the California Office of Statewide Health Planning and Development between January 1, 2006, and December 31, 2015, were used to categorize hospitals according to Health Professional Shortage Area location. A difference-in-differences analysis measured the effect of the Surgery Incentive Payment on year-to-year differences for inpatient and outpatient surgical procedures by hospital type pre- (2006-2010) versus post- (2011-2015) Surgery Incentive Payment implementation. Among 409 unique hospitals that performed surgical procedures for at least 1 year of the study period, 2 performed surgery in a designated Health Professional Shortage Area. The two Health Professional Shortage Area -designated hospitals were located in a rural area, were non-teaching hospitals, and had 196 and 202 hospital beds, respectively. After the enactment of the Surgery Incentive Payment, while non- Health Professional Shortage Areas had only a modest relative decrease in total inpatient procedures (Pre-Surgery Incentive Payment: 4,666,938 versus Post-Surgery Incentive Payment: 4,451,612; Δ-4.6%), the proportional decrease in inpatient surgical procedures at Health Professional Shortage Area hospitals was more marked (Pre-Surgery Incentive Payment: 25,830 versus Post-Surgery Incentive Payment: 21,503; Δ-16.7%). In contrast, Health Professional Shortage Area hospitals proportionally had a greater increase in total outpatient procedures (Pre-Surgery Incentive Payment: 17,840 versus Post-Surgery Incentive Payment: 22,375: Δ+25.4%) versus non- Health Professional Shortage Area hospitals (Pre-Surgery Incentive Payment: 5,863,300 versus Post-Surgery Incentive Payment: 6,156,138; Δ+4.9%). Based on the difference-in-differences analysis, the increase in the trend of surgical procedures at Health Professional Shortage Area hospitals was much more notable after Surgery Incentive Payment implementation (Δ+75.2%). The Medicare Surgery Incentive Payment program was associated with an increase in the number of surgical procedures performed at Health Professional Shortage Area hospitals relative to non-Health Professional Shortage Area hospitals during the study period, reversing the trend from negative to positive. Copyright © 2018 Elsevier Inc. All rights reserved.

The Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+Choice Plans

PubMed Central

Buntin, Melinda Beeuwkes; Garber, Alan M; McClellan, Mark; Newhouse, Joseph P

2004-01-01

Objective To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life—a group that accounts for more than one-quarter of Medicare's annual expenditures. Data Source Medicare administrative claims for 1994 and 1995. Study Design We calculated the payment a plan would have received under three risk-adjustment systems for each beneficiary in our 1995 sample based on his or her age, gender, county of residence, original reason for Medicare entitlement, and principal inpatient diagnoses received during any hospital stays in 1994. We compared these amounts to the actual costs incurred by those beneficiaries. We then looked for clinical categories that were predictive of costs, including costs in a beneficiary's last year of life, not accounted for by the risk adjusters. Data Extraction Methods The analyses were conducted using claims for a 5 percent random sample of Medicare beneficiaries who died in 1995 and a matched group of survivors. Principal Findings Medicare is currently implementing the Principal Inpatient Diagnostic Cost Groups (PIP-DCG) risk adjustment payment system to address the problem of risk selection in the Medicare+Choice program. We quantify the strong financial disincentives to enroll terminally ill beneficiaries that plans still have under this risk adjustment system. We also show that up to one-third of the selection observed between Medicare HMOs and the traditional fee-for-service system could be due to differential enrollment of decedents. A risk adjustment system that incorporated more of the available diagnostic information would attenuate this disincentive; however, plans could still use clinical information (not included in the risk adjustment scheme) to identify beneficiaries whose expected costs exceed expected payments. Conclusions More disaggregated prospective risk adjustment methods and alternative payment systems that compensate plans for delivering care to certain classes of patients should be considered to ensure access to high-quality managed care for all beneficiaries. PMID:14965080

75 FR 46169 - Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and CY...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

...This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act). In this proposed rule, we describe the proposed changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These proposed changes would be applicable to services furnished on or after January 1, 2011. In addition, this proposed rule would update the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act. In this proposed rule, we set forth the proposed applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these proposed changes would apply, and other pertinent ratesetting information for the CY 2011 ASC payment system. These proposed changes would be applicable to services furnished on or after January 1, 2011. This proposed rule also includes proposals to implement provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education (GME) and indirect medical education (IME) costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest.

20 CFR 323.3 - Standards for Board approval of a nongovernmental plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.3 Standards for Board approval of a nongovernmental plan. An unemployment or sickness benefit plan qualifies... conditions governing payment of benefits under the Railroad Unemployment Insurance Act. However, a plan will...

20 CFR 323.3 - Standards for Board approval of a nongovernmental plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.3 Standards for Board approval of a nongovernmental plan. An unemployment or sickness benefit plan qualifies... conditions governing payment of benefits under the Railroad Unemployment Insurance Act. However, a plan will...

20 CFR 323.3 - Standards for Board approval of a nongovernmental plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.3 Standards for Board approval of a nongovernmental plan. An unemployment or sickness benefit plan qualifies... conditions governing payment of benefits under the Railroad Unemployment Insurance Act. However, a plan will...

20 CFR 323.3 - Standards for Board approval of a nongovernmental plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.3 Standards for Board approval of a nongovernmental plan. An unemployment or sickness benefit plan qualifies... conditions governing payment of benefits under the Railroad Unemployment Insurance Act. However, a plan will...

5 CFR 890.702 - Payment to any licensed practitioner.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits in Medically Underserved Areas..., if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost...

5 CFR 890.702 - Payment to any licensed practitioner.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits in Medically Underserved Areas..., if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost...

5 CFR 890.702 - Payment to any licensed practitioner.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits in Medically Underserved Areas..., if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost...

5 CFR 890.702 - Payment to any licensed practitioner.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits in Medically Underserved Areas..., if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost...

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...

Pricing Models and Payment Schemes for Library Collections.

ERIC Educational Resources Information Center

Stern, David

2002-01-01

Discusses new pricing and payment options for libraries in light of online products. Topics include alternative cost models rather than traditional subscriptions; use-based pricing; changes in scholarly communication due to information technology; methods to determine appropriate charges for different organizations; consortial plans; funding; and…

7 CFR 97.178 - Refunds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... VARIETY AND PROTECTION Fees and Charges § 97.178 Refunds. Money paid by mistake or excess payments shall be refunded, but a mere change of plans after the payment of money, as when a party decides to... of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections...

42 CFR 413.100 - Special treatment of certain accrued costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific...) If the sick leave plan grants employees the nonforfeitable right to demand cash payment for unused... reporting periods that produce the highest average contribution(s), out of the five most recent Medicare...

42 CFR 413.100 - Special treatment of certain accrued costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific...) If the sick leave plan grants employees the nonforfeitable right to demand cash payment for unused... reporting periods that produce the highest average contribution(s), out of the five most recent Medicare...

Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance

PubMed Central

Geruso, Michael; McGuire, Thomas G.

2016-01-01

In many markets, including the new U.S. Marketplaces, health insurance plans are paid by risk-adjusted capitation, sometimes combined with reinsurance and other payment mechanisms. This paper proposes a framework for evaluating the de facto insurer incentives embedded in these complex payment systems. We discuss fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement empirical metrics of fit, power, and balance in a study of Marketplace payment systems. Using data similar to that used to develop the Marketplace risk adjustment scheme, we quantify tradeoffs among the three classes of incentives. We show that an essential tradeoff arises between the goals of limiting costs and limiting cream skimming because risk adjustment, which is aimed at discouraging cream-skimming, weakens cost control incentives in practice. A simple reinsurance system scores better on our measures of fit, power and balance than the risk adjustment scheme in use in the Marketplaces. PMID:26922122

Tradeoffs in the design of health plan payment systems: Fit, power and balance.

PubMed

Geruso, Michael; McGuire, Thomas G

2016-05-01

In many markets, including the new U.S. Marketplaces, health insurance plans are paid by risk-adjusted capitation, sometimes combined with reinsurance and other payment mechanisms. This paper proposes a framework for evaluating the de facto insurer incentives embedded in these complex payment systems. We discuss fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement empirical metrics of fit, power, and balance in a study of Marketplace payment systems. Using data similar to that used to develop the Marketplace risk adjustment scheme, we quantify tradeoffs among the three classes of incentives. We show that an essential tradeoff arises between the goals of limiting costs and limiting cream skimming because risk adjustment, which is aimed at discouraging cream-skimming, weakens cost control incentives in practice. A simple reinsurance system scores better on our measures of fit, power and balance than the risk adjustment scheme in use in the Marketplaces. Copyright © 2016 Elsevier B.V. All rights reserved.

29 CFR 2590.712 - Parity in mental health and substance use disorder benefits.

Code of Federal Regulations, 2013 CFR

2013-07-01

.../surgical benefits related to cardio-pulmonary diseases. The plan does not include an annual dollar limit on... plan payments for medical/surgical benefits are related to cardio-pulmonary diseases. The plan...

29 CFR 2590.712 - Parity in mental health and substance use disorder benefits.

Code of Federal Regulations, 2012 CFR

2012-07-01

.../surgical benefits related to cardio-pulmonary diseases. The plan does not include an annual dollar limit on... plan payments for medical/surgical benefits are related to cardio-pulmonary diseases. The plan...

45 CFR 146.136 - Parity in mental health and substance use disorder benefits.

Code of Federal Regulations, 2011 CFR

2011-10-01

.../surgical benefits related to cardio-pulmonary diseases. The plan does not include an annual dollar limit on... plan payments for medical/surgical benefits are related to cardio-pulmonary diseases. The plan...

45 CFR 146.136 - Parity in mental health and substance use disorder benefits.

Code of Federal Regulations, 2013 CFR

2013-10-01

.../surgical benefits related to cardio-pulmonary diseases. The plan does not include an annual dollar limit on... plan payments for medical/surgical benefits are related to cardio-pulmonary diseases. The plan...

45 CFR 146.136 - Parity in mental health and substance use disorder benefits.

Code of Federal Regulations, 2012 CFR

2012-10-01

.../surgical benefits related to cardio-pulmonary diseases. The plan does not include an annual dollar limit on... plan payments for medical/surgical benefits are related to cardio-pulmonary diseases. The plan...

29 CFR 2590.712 - Parity in mental health and substance use disorder benefits.

Code of Federal Regulations, 2011 CFR

2011-07-01

.../surgical benefits related to cardio-pulmonary diseases. The plan does not include an annual dollar limit on... plan payments for medical/surgical benefits are related to cardio-pulmonary diseases. The plan...

COMPETITIVE BIDDING IN MEDICARE ADVANTAGE: EFFECT OF BENCHMARK CHANGES ON PLAN BIDS

PubMed Central

Song, Zirui; Landrum, Mary Beth; Chernew, Michael E.

2013-01-01

Bidding has been proposed to replace or complement the administered prices in Medicare pays to hospitals and health plans. In 2006, the Medicare Advantage program implemented a competitive bidding system to determine plan payments. In perfectly competitive models, plans bid their costs and thus bids are insensitive to the benchmark. Under many other models of competition, bids respond to changes in the benchmark. We conceptualize the bidding system and use an instrumental variable approach to study the effect of benchmark changes on bids. We use 2006–2010 plan payment data from the Centers for Medicare and Medicaid Services, published county benchmarks, actual realized fee-for-service costs, and Medicare Advantage enrollment. We find that a $1 increase in the benchmark leads to about a $0.53 increase in bids, suggesting that plans in the Medicare Advantage market have meaningful market power. PMID:24308881

Competitive bidding in Medicare Advantage: effect of benchmark changes on plan bids.

PubMed

Song, Zirui; Landrum, Mary Beth; Chernew, Michael E

2013-12-01

Bidding has been proposed to replace or complement the administered prices that Medicare pays to hospitals and health plans. In 2006, the Medicare Advantage program implemented a competitive bidding system to determine plan payments. In perfectly competitive models, plans bid their costs and thus bids are insensitive to the benchmark. Under many other models of competition, bids respond to changes in the benchmark. We conceptualize the bidding system and use an instrumental variable approach to study the effect of benchmark changes on bids. We use 2006-2010 plan payment data from the Centers for Medicare and Medicaid Services, published county benchmarks, actual realized fee-for-service costs, and Medicare Advantage enrollment. We find that a $1 increase in the benchmark leads to about a $0.53 increase in bids, suggesting that plans in the Medicare Advantage market have meaningful market power. Copyright © 2013 Elsevier B.V. All rights reserved.

7 CFR 1427.1200 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Competitiveness Payment Program § 1427.1200 Applicability. (a) These regulations set forth the terms and... collections necessary in administering the ELS cotton competitiveness payment program. Additional terms and...

29 CFR 4006.5 - Exemptions and special rules.

Code of Federal Regulations, 2014 CFR

2014-07-01

... year. (4) Certain small new and newly covered plans. A plan is described in this paragraph if— (i) It is a small plan other than a continuation plan, and (ii) It is a new plan or a newly covered plan. (b... the plan year preceding the premium payment year. (d) Participant count date; new and newly covered...

Medicaid integrity program; limitation on contractor liability. Final rule.

PubMed

2007-11-30

The Medicaid Integrity Program (the Program) provides that the Secretary promote the integrity of the Medicaid program by entering into contracts with contractors that will review the actions of individuals or entities furnishing items or services (whether fee-for-service, risk, or other basis) for which payment may be made under an approved State plan and/or any waiver of the plan approved under section 1115 of the Social Security Act; audit claims for payment of items or services furnished, or administrative services furnished, under a State plan; identify overpayments of individuals or entities receiving Federal funds; and educate providers of services, managed care entities, beneficiaries, and other individuals with respect to payment integrity and quality of care. This final rule will provide for limitations on a contractor's liability while performing these services under the Program. The final rule will, to the extent possible, employ the same or comparable standards and other substantive and procedural provisions as are contained in section 1157 (Limitation on Liability) of the Social Security Act.

Payment system reform: one state's journey.

PubMed

Millwee, Billy; Goldfield, Norbert; Averill, Richard; Hughes, John

2013-01-01

In June 2011, Texas enacted Senate Bill 7, which mandates a Medicaid quality-based outcomes payment program on the basis of a common set of outcomes that apply to all types of provider systems including hospitals, managed care plans, medical homes, managed long-term care plans, and Accountable Care Organizations. The quality-based outcome measures focus on potentially preventable events (services) such as preventable admissions and readmissions that result in unnecessary expense, patient inconvenience, and risk of complications. The payment adjustments relate to a provider system's effectiveness in reducing the rate at which potentially preventable events occur. The program envisioned by Texas Medicaid is one that is administratively simple, establishes the right financial incentives to drive delivery system improvement, and does not intrude on the provider practice or the patient. Rather than imposing a series of processes that must be followed or require rigid adherence to standardized protocols, the payment adjustments are based on risk-adjusted comparisons of the rate of potentially preventable events for an individual provider systems to an empirically derived performance standard such as the state average. This article proposes a payment system design that can meet the ambitious objectives of the Texas legislation.

7 CFR 4288.112 - Eligibility notifications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... applicant a contract number. (b) Ineligibility notifications. If an applicant or a biofuel is determined by... after receipt of the application, as to the reason(s) the applicant or biofuel was determined to be...

7 CFR 4288.112 - Eligibility notifications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... number. (b) Ineligibility notifications. If an applicant or a biofuel is determined by the Agency to be... application, as to the reason(s) the applicant or biofuel was determined to be ineligible. Such applicant will...

7 CFR 4288.112 - Eligibility notifications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... number. (b) Ineligibility notifications. If an applicant or a biofuel is determined by the Agency to be... application, as to the reason(s) the applicant or biofuel was determined to be ineligible. Such applicant will...

12 CFR 714.8 - Are the early payment provisions, or interest rate provisions, applicable in leasing arrangements?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Are the early payment provisions, or interest... CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS LEASING § 714.8 Are the early payment provisions, or interest rate provisions, applicable in leasing arrangements? You are not subject to the early...

42 CFR 457.616 - Application and tracking of payments against the fiscal year allotments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Application and tracking of payments against the fiscal year allotments. 457.616 Section 457.616 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Payments to...

42 CFR 457.616 - Application and tracking of payments against the fiscal year allotments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Application and tracking of payments against the fiscal year allotments. 457.616 Section 457.616 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Payments to...

42 CFR 457.616 - Application and tracking of payments against the fiscal year allotments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Application and tracking of payments against the fiscal year allotments. 457.616 Section 457.616 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Payments to...

42 CFR 457.616 - Application and tracking of payments against the fiscal year allotments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Application and tracking of payments against the fiscal year allotments. 457.616 Section 457.616 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Payments to...

42 CFR 457.616 - Application and tracking of payments against the fiscal year allotments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Application and tracking of payments against the fiscal year allotments. 457.616 Section 457.616 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Payments to...

The effects of market structure and payment rate on the entry of private health plans into the Medicare market.

PubMed

Frakt, Austin B; Pizer, Steven D; Feldman, Roger

2012-01-01

Private insurance firms participating in Medicare can offer up to three principal plan types: coordinated care plans (CCPs), prescription drug plans (PDPs), and private fee-for-service (PFFS) plans. Firms can make entry and marketing decisions separately across plan types and geographic regions. In this study, we estimate firm-level models of Medicare private plan entry using data from the years 2007 to 2009. Our models include a measure of market structure and separately identify CCP, PDP, and PFFS entry. We find evidence that entry barriers associated with CCP market concentration affect all three product types. We also find evidence of cross-product competition and common cost or demand factors that make entry with certain product combinations more likely. We predict that the market presence of CCPs and PFFS plans will decrease and that of PDPs will increase in response to payment reductions included in the new health reform law.

7 CFR 784.1 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SPECIAL PROGRAMS 2004 EWE LAMB REPLACEMENT AND RETENTION PAYMENT PROGRAM § 784.1 Applicability. (a... Lamb Replacement and Retention Payment Program will be administered. (b) Unless otherwise determined by...

Diagnosis-related group (DRG)-based case-mix funding system, a promising alternative for fee for service payment in China.

PubMed

Zhao, Cuirong; Wang, Chao; Shen, Chengwu; Wang, Qian

2018-05-13

Fee for services (FFS) is the prevailing method of payment in most Chinese public hospitals. Under this retrospective payment system, medical care providers are paid based on medical services and tend to over-treat to maximize their income, thereby contributing to rising medical costs and uncontrollable health expenditures to a large extent. Payment reform needs to be promptly implemented to move to a prospective payment plan. The diagnosis-related group (DRG)-based case-mix payment system, with its superior efficiency and containment of costs, has garnered increased attention and it represents a promising alternative. This article briefly describes the DRG-based case-mix payment system, it comparatively analyzes differences between FFS and case-mix funding systems, and it describes the implementation of DRGs in China. China's social and economic conditions differ across regions, so establishment of a national payment standard will take time and involve difficulties. No single method of provider payment is perfect. Measures to monitor and minimize the negative ethical implications and unintended effects of a DRG-based case-mix payment system are essential to ensuring the lasting social benefits of payment reform in Chinese public hospitals.

7 CFR 760.3 - Indemnity payments on milk.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Indemnity payments on milk. 760.3 Section 760.3... Farmers for Milk § 760.3 Indemnity payments on milk. An indemnity payment for milk may be made to an... whole milk marketed during the applications period, and (b) any payment not subject to refund which he...

7 CFR 760.3 - Indemnity payments on milk.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Indemnity payments on milk. 760.3 Section 760.3... Farmers for Milk § 760.3 Indemnity payments on milk. An indemnity payment for milk may be made to an... whole milk marketed during the applications period, and (b) any payment not subject to refund which he...

7 CFR 760.3 - Indemnity payments on milk.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Indemnity payments on milk. 760.3 Section 760.3... Farmers for Milk § 760.3 Indemnity payments on milk. An indemnity payment for milk may be made to an... whole milk marketed during the applications period, and (b) any payment not subject to refund which he...

7 CFR 760.3 - Indemnity payments on milk.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Indemnity payments on milk. 760.3 Section 760.3... Farmers for Milk § 760.3 Indemnity payments on milk. An indemnity payment for milk may be made to an... whole milk marketed during the applications period, and (b) any payment not subject to refund which he...

7 CFR 760.3 - Indemnity payments on milk.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Indemnity payments on milk. 760.3 Section 760.3... Farmers for Milk § 760.3 Indemnity payments on milk. An indemnity payment for milk may be made to an... whole milk marketed during the applications period, and (b) any payment not subject to refund which he...

26 CFR 31.3121(a)(13)-1 - Payments under certain employers' plans after retirement, disability, or death.

Code of Federal Regulations, 2011 CFR

2011-04-01

... section and section 3121(a)(13). For example, lump-sum payments for unused vacation time or a final... is paid or commences to be paid upon or within a reasonable time after the termination of an employee...

26 CFR 31.3121(a)(13)-1 - Payments under certain employers' plans after retirement, disability, or death.

Code of Federal Regulations, 2010 CFR

2010-04-01

... section and section 3121(a)(13). For example, lump-sum payments for unused vacation time or a final... is paid or commences to be paid upon or within a reasonable time after the termination of an employee...

Notification: Risk Assessment of CSB’s Purchase Card Usage and CSB’s Compliance with the Improper Payments Legislation

EPA Pesticide Factsheets

November 6, 2014. The EPA's OIG for the U.S. Chemical Safety and Hazard Investigation Board (CSB) plans to begin its risk assessment of CSB's purchase card usage and CSB's compliance with the improper payments legislation.

10 CFR 603.1100 - Contracting officer's post-award responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... technical progress, financial status, and future program plans. (b) Tracking and processing of reports... progress reports, and patent reports. (c) Handling payment requests and related matters. For a TIA using advance payments, that includes reviews of progress to verify that there is continued justification for...

7 CFR 4287.170 - Bankruptcy.

Code of Federal Regulations, 2011 CFR

2011-01-01

... reorganization whenever it appears that additional recoveries are likely. (4) The Agency will be kept adequately... reorganization plan and the borrower repays in full the remaining balance without an additional loss sustained by... payment, the lender will submit a revised estimated loss in order to obtain payment of the additional...

7 CFR 4287.170 - Bankruptcy.

Code of Federal Regulations, 2012 CFR

2012-01-01

... reorganization whenever it appears that additional recoveries are likely. (4) The Agency will be kept adequately... reorganization plan and the borrower repays in full the remaining balance without an additional loss sustained by... payment, the lender will submit a revised estimated loss in order to obtain payment of the additional...

7 CFR 4287.170 - Bankruptcy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... reorganization whenever it appears that additional recoveries are likely. (4) The Agency will be kept adequately... reorganization plan and the borrower repays in full the remaining balance without an additional loss sustained by... payment, the lender will submit a revised estimated loss in order to obtain payment of the additional...

7 CFR 4287.170 - Bankruptcy.

Code of Federal Regulations, 2013 CFR

2013-01-01

... reorganization whenever it appears that additional recoveries are likely. (4) The Agency will be kept adequately... reorganization plan and the borrower repays in full the remaining balance without an additional loss sustained by... payment, the lender will submit a revised estimated loss in order to obtain payment of the additional...

7 CFR 4287.170 - Bankruptcy.

Code of Federal Regulations, 2014 CFR

2014-01-01

... reorganization whenever it appears that additional recoveries are likely. (4) The Agency will be kept adequately... reorganization plan and the borrower repays in full the remaining balance without an additional loss sustained by... payment, the lender will submit a revised estimated loss in order to obtain payment of the additional...

10 CFR 436.36 - Conditions of payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... baseline under the energy savings performance contract (adjusted if appropriate under § 436.37), multiplied... 10 Energy 3 2010-01-01 2010-01-01 false Conditions of payment. 436.36 Section 436.36 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methods and...

5 CFR 1315.18 - Inquiries.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES PROMPT PAYMENT § 1315.18 Inquiries. (a..., Financial Management Service (FMS), Cash Management Policy and Planning Division, 401 14th Street, SW... Management Service (FMS) at 1-800-266-9667. This information is also available at the FMS Prompt Payment Web...

20 CFR 633.104 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... from sources such as net rents, Old Age and Survivors Insurance, Social Security benefits, pensions... payments received pursuant to a State plan approved under titles I, IV, X or XVI of the Social Security Act, or disability insurance payments received under title II of the Social Security Act; (5) Federal...

5 CFR 1315.18 - Inquiries.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., Financial Management Service (FMS), Cash Management Policy and Planning Division, 401 14th Street, SW... Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES PROMPT PAYMENT § 1315.18 Inquiries. (a... Management Service (FMS) at 1-800-266-9667. This information is also available at the FMS Prompt Payment Web...

Explaining the discrepancy between intentions and actions: the case of hypothetical bias in contingent valuation.

PubMed

Ajzen, Icek; Brown, Thomas C; Carvajal, Franklin

2004-09-01

An experiment was designed to account for intention-behavior discrepancies by applying the theory of planned behavior to contingent valuation. College students (N = 160) voted in hypothetical and real payment referenda to contribute $8 to a scholarship fund. Overestimates of willingness to pay in the hypothetical referendum could not be attributed to moderately favorable latent dispositions. Instead, this hypothetical bias was explained by activation of more favorable beliefs and attitudes in the context of a hypothetical rather than a real referendum. A corrective entreaty was found to eliminate this bias by bringing beliefs, attitudes, and intentions in line with those in the real payment situation. As a result, the theory of planned behavior produced more accurate prediction of real payment when participants were exposed to the corrective entreaty.

Integrated landscape planning and remuneration of agri-environmental services. Results of a case study in the Fuhrberg region of Germany.

PubMed

V Haaren, Christina; Bathke, Manfred

2008-11-01

Until now, existing remuneration of environmental services has not sufficiently supported the goals of spending money more effectively on the environment and of motivating farmers. Only a small share of the budgets for agriculture in the EU, as well as in US and other countries, is available for buying environmental goods and services beyond the level of good farming practice (GFP). This combined with the insufficient targeting of compensation payments to areas where special measures are needed leads to an unsatisfactorily low impact of agri-environment measures compared to other driving forces that stimulate the intensification of farming. The goal of this paper is to propose a management concept that enhances the ecological and cost efficiency of agri-environment measures. Components of the concept are a comprehensive environmental information base with prioritised goals and targets (available in Germany from landscape planning) and new remuneration models, which complement conventional compensation payments that are based upon predetermined measures and cost. Comprehensive landscape planning locates and prioritises areas which require environmental action. It contains the information that authorities need to prioritise funding for environmental services and direct measures to sites which need environmental services beyond the level of GFP. Also appropriate remuneration models, which can enhance the cost efficiency of public spending and the motivation of the farmers, can be applied on the base of landscape planning. Testing of the planning methodology and of one of the remuneration models (success-oriented remuneration) in a case study area ("Fuhrberger Feld" north of Hanover, Germany) demonstrated the usability of the concept and led to proposals for future development of the methodology and its application in combination with other approaches.

Multiple payers, commonality and free-riding in health care: Medicare and private payers.

PubMed

Glazer, Jacob; McGuire, Thomas G

2002-11-01

Managed health care plans and providers in the US and elsewhere sell their services to multiple payers. For example, the three largest groups of purchasers from health plans in the US are employers, Medicaid plans, and Medicare, with the first two accounting for over 90% of the total enrollees. In the case of hospitals, Medicare is the largest buyer, but it alone only accounts for 40% of the total payments. While payers have different objectives and use different contracting practices, the plans and providers set some elements of the quality in common for all payers. In this paper, we study the interactions between a public payer, modeled on Medicare, which sets a price and takes any willing provider, a private payer, which limits providers and pays a price on the basis of quality, and a provider/plan, in the presence of shared elements of quality. The provider compromises in response to divergent incentives from payers. The private sector dilutes Medicare payment initiatives, and may, under some circumstances, repair Medicare payment policy mistakes. If Medicare behaves strategically in the presence of private payers, it can free-ride on the private payer and set its prices too low. Our paper has many testable implications, including a new hypothesis for why Medicare has failed to gain acceptance of health plans in the US.

42 CFR 412.332 - Payment based on the hospital-specific rate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital Capital Costs Determination of Transition Period Payment Rates for... (f) is determined by multiplying the applicable hospital-specific rate by the DRG weighting factor...

45 CFR 156.80 - Single risk pool.

Code of Federal Regulations, 2014 CFR

2014-10-01

... claims experience of all enrollees in all health plans (other than grandfathered health plans) subject to... experience of all enrollees in all health plans (other than grandfathered health plans) subject to section... market-wide payments and charges under the risk adjustment and reinsurance programs, and Exchange user...

45 CFR 156.80 - Single risk pool.

Code of Federal Regulations, 2013 CFR

2013-10-01

... claims experience of all enrollees in all health plans (other than grandfathered health plans) subject to... experience of all enrollees in all health plans (other than grandfathered health plans) subject to section... payments and charges under the risk adjustment and reinsurance programs, and Exchange user fees (expected...

Gold and Silver Health Plans: Accommodating Demand Heterogeneity in Managed Competition

PubMed Central

Glazer, Jacob; McGuire, Thomas G.

2011-01-01

New regulation of health insurance markets creates multiple levels of health plans, with designations like “Gold” and “Silver”. The underlying rationale for the heavy-metal approach to insurance regulation is that heterogeneity in demand for health care is not only due to health status (sick demand more than the healthy) but also to other, “taste” related factors (rich demand more than the poor). This paper models managed competition with demand heterogeneity to consider plan payment and enrollee premium policies in relation to efficiency (net consumer benefit) and fairness (the European concept of “solidarity”). Specifically, this paper studies how to implement a “Silver” and “Gold” health plan efficiently and fairly in a managed competition context. We show that there are sharp tradeoffs between efficiency and fairness. When health plans cannot or may not (because of regulation) base premiums on any factors affecting demand, enrollees do not choose the efficient plan. When taste (e.g. income) can be used as a basis of payment, a simple tax can achieve both efficiency and fairness. When only health status (and not taste) can be used as a basis of payment, health status-based taxes and subsidies are required and efficiency can only be achieved with a modified version of fairness we refer to as “weak solidarity.” An overriding conclusion is that the regulation of premiums for both the basic and the higher level plans is necessary for efficiency. PMID:21767887

Impact of Medicare Advantage Prescription Drug Plan Star Ratings on Enrollment before and after Implementation of Quality-Related Bonus Payments in 2012

PubMed Central

Li, Pengxiang; Doshi, Jalpa A.

2016-01-01

Objective Since 2007, the Centers for Medicare and Medicaid Services have published 5-star quality rating measures to aid consumers in choosing Medicare Advantage Prescription Drug Plans (MAPDs). We examined the impact of these star ratings on Medicare Advantage Prescription Drug (MAPD) enrollment before and after 2012, when star ratings became tied to bonus payments for MAPDs that could be used to improve plan benefits and/or reduce premiums in the subsequent year. Methods A longitudinal design and multivariable hybrid models were used to assess whether star ratings had a direct impact on concurrent year MAPD contract enrollment (by influencing beneficiary choice) and/or an indirect impact on subsequent year MAPD contract enrollment (because ratings were linked to bonus payments). The main analysis was based on contract-year level data from 2009–2015. We compared effects of star ratings in the pre-bonus payment period (2009–2011) and post-bonus payment period (2012–2015). Extensive sensitivity analyses varied the analytic techniques, unit of analysis, and sample inclusion criteria. Similar analyses were conducted separately using stand-alone PDP contract-year data; since PDPs were not eligible for bonus payments, they served as an external comparison group. Result The main analysis included 3,866 MAPD contract-years. A change of star rating had no statistically significant effect on concurrent year enrollment in any of the pre-, post-, or pre-post combined periods. On the other hand, star rating increase was associated with a statistically significant increase in the subsequent year enrollment (a 1-star increase associated with +11,337 enrollees, p<0.001) in the post-bonus payment period but had a very small and statistically non-significant effect on subsequent year enrollment in the pre-bonus payment period. Further, the difference in effects on subsequent year enrollment was statistically significant between the pre- and post-periods (p = 0.011). Sensitivity analyses indicated that the findings were robust. No statistically significant effect of star ratings was found on concurrent or subsequent year enrollment in the pre- or post-period in the external comparison group of stand-alone PDP contracts. Conclusion Star ratings had no direct impact on concurrent year MAPD enrollment before or after the introduction of bonus payments tied to star ratings. However, after the introduction of these bonus payments, MAPD star ratings had a significant indirect impact of increasing subsequent year enrollment, likely via the reinvestment of bonuses to provide lower premiums and/or additional member benefits in the following year. PMID:27149092

Impact of Medicare Advantage Prescription Drug Plan Star Ratings on Enrollment before and after Implementation of Quality-Related Bonus Payments in 2012.

PubMed

Li, Pengxiang; Doshi, Jalpa A

2016-01-01

Since 2007, the Centers for Medicare and Medicaid Services have published 5-star quality rating measures to aid consumers in choosing Medicare Advantage Prescription Drug Plans (MAPDs). We examined the impact of these star ratings on Medicare Advantage Prescription Drug (MAPD) enrollment before and after 2012, when star ratings became tied to bonus payments for MAPDs that could be used to improve plan benefits and/or reduce premiums in the subsequent year. A longitudinal design and multivariable hybrid models were used to assess whether star ratings had a direct impact on concurrent year MAPD contract enrollment (by influencing beneficiary choice) and/or an indirect impact on subsequent year MAPD contract enrollment (because ratings were linked to bonus payments). The main analysis was based on contract-year level data from 2009-2015. We compared effects of star ratings in the pre-bonus payment period (2009-2011) and post-bonus payment period (2012-2015). Extensive sensitivity analyses varied the analytic techniques, unit of analysis, and sample inclusion criteria. Similar analyses were conducted separately using stand-alone PDP contract-year data; since PDPs were not eligible for bonus payments, they served as an external comparison group. The main analysis included 3,866 MAPD contract-years. A change of star rating had no statistically significant effect on concurrent year enrollment in any of the pre-, post-, or pre-post combined periods. On the other hand, star rating increase was associated with a statistically significant increase in the subsequent year enrollment (a 1-star increase associated with +11,337 enrollees, p<0.001) in the post-bonus payment period but had a very small and statistically non-significant effect on subsequent year enrollment in the pre-bonus payment period. Further, the difference in effects on subsequent year enrollment was statistically significant between the pre- and post-periods (p = 0.011). Sensitivity analyses indicated that the findings were robust. No statistically significant effect of star ratings was found on concurrent or subsequent year enrollment in the pre- or post-period in the external comparison group of stand-alone PDP contracts. Star ratings had no direct impact on concurrent year MAPD enrollment before or after the introduction of bonus payments tied to star ratings. However, after the introduction of these bonus payments, MAPD star ratings had a significant indirect impact of increasing subsequent year enrollment, likely via the reinvestment of bonuses to provide lower premiums and/or additional member benefits in the following year.

75 FR 79000 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... States submit pricing information for the 50 most widely prescribed drugs so that the States' prices can be compared to the national average prices obtained from the survey. The States pricing information... health care payment and remittance advices, transmit health plan premium payments, determine health care...

42 CFR 457.626 - Prevention of duplicate payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... to a State for expenditures for child health assistance under its State child health plan to the... 42 Public Health 4 2014-10-01 2014-10-01 false Prevention of duplicate payments. 457.626 Section 457.626 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 457.626 - Prevention of duplicate payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... to a State for expenditures for child health assistance under its State child health plan to the... 42 Public Health 4 2013-10-01 2013-10-01 false Prevention of duplicate payments. 457.626 Section 457.626 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 457.626 - Prevention of duplicate payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... to a State for expenditures for child health assistance under its State child health plan to the... 42 Public Health 4 2010-10-01 2010-10-01 false Prevention of duplicate payments. 457.626 Section 457.626 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 457.626 - Prevention of duplicate payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... to a State for expenditures for child health assistance under its State child health plan to the... 42 Public Health 4 2011-10-01 2011-10-01 false Prevention of duplicate payments. 457.626 Section 457.626 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 457.626 - Prevention of duplicate payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... to a State for expenditures for child health assistance under its State child health plan to the... 42 Public Health 4 2012-10-01 2012-10-01 false Prevention of duplicate payments. 457.626 Section 457.626 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

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...

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...

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...

42 CFR 422.252 - Terminology.

Code of Federal Regulations, 2010 CFR

2010-10-01

... § 422.252 Terminology. Annual MA capitation rate means a county payment rate for an MA local area... to refer to the annual MA capitation rate. MA local area means a payment area consisting of county or equivalent area specified by CMS. MA monthly basic beneficiary premium means the premium amount an MA plan...

42 CFR 423.315 - General payment provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... following payment year based on the relationship of the Part D plan's adjusted allowable risk corridor costs to predetermined risk corridor thresholds in the coverage year as provided in § 423.336. (f...). (2) Exemption from risk corridor provisions. The provisions of § 423.336 regarding risk sharing do...

42 CFR 423.315 - General payment provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... following payment year based on the relationship of the Part D plan's adjusted allowable risk corridor costs to predetermined risk corridor thresholds in the coverage year as provided in § 423.336. (f...). (2) Exemption from risk corridor provisions. The provisions of § 423.336 regarding risk sharing do...

42 CFR 423.315 - General payment provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... following payment year based on the relationship of the Part D plan's adjusted allowable risk corridor costs to predetermined risk corridor thresholds in the coverage year as provided in § 423.336. (f...). (2) Exemption from risk corridor provisions. The provisions of § 423.336 regarding risk sharing do...

42 CFR 423.315 - General payment provisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... following payment year based on the relationship of the Part D plan's adjusted allowable risk corridor costs to predetermined risk corridor thresholds in the coverage year as provided in § 423.336. (f...). (2) Exemption from risk corridor provisions. The provisions of § 423.336 regarding risk sharing do...

42 CFR 423.315 - General payment provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... following payment year based on the relationship of the Part D plan's adjusted allowable risk corridor costs to predetermined risk corridor thresholds in the coverage year as provided in § 423.336. (f...). (2) Exemption from risk corridor provisions. The provisions of § 423.336 regarding risk sharing do...

20 CFR 404.1049 - Payments under an employer plan or system.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income... the termination of your employment relationship because of your death or retirement for disability are... disability; or (2) Death, except that the exclusion does not apply to payments for group-term life insurance...

20 CFR 404.1049 - Payments under an employer plan or system.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income... the termination of your employment relationship because of your death or retirement for disability are... disability; or (2) Death, except that the exclusion does not apply to payments for group-term life insurance...

20 CFR 404.1049 - Payments under an employer plan or system.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income... the termination of your employment relationship because of your death or retirement for disability are... disability; or (2) Death, except that the exclusion does not apply to payments for group-term life insurance...

20 CFR 404.1049 - Payments under an employer plan or system.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income... the termination of your employment relationship because of your death or retirement for disability are... disability; or (2) Death, except that the exclusion does not apply to payments for group-term life insurance...

20 CFR 404.1049 - Payments under an employer plan or system.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income... the termination of your employment relationship because of your death or retirement for disability are... disability; or (2) Death, except that the exclusion does not apply to payments for group-term life insurance...

5 CFR 890.105 - Filing claims for payment or service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administration and General Provisions § 890.105 Filing claims for payment or service. (a) General. (1) Each health benefits carrier resolves claims filed under the plan. All health benefits claims must be submitted initially to the carrier of the...

45 CFR 1356.20 - State plan document and submission requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES... (FFP) in the costs of foster care maintenance payments and adoption assistance under this part, a State... and standards for the data reporting system for foster care and adoption (§ 1355.40 of this chapter...

36 CFR 230.9 - Payment to landowners.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Payment to landowners. 230.9 Section 230.9 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND... needed to meet the objectives of the landowner forest stewardship plan; or (2) The landowner establishes...

36 CFR 230.9 - Payment to landowners.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Payment to landowners. 230.9 Section 230.9 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND... needed to meet the objectives of the landowner forest stewardship plan; or (2) The landowner establishes...

42 CFR 417.800 - Payment to HCPPs: Definitions and basic rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to HCPPs: Definitions and basic rules. 417... HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS... and basic rules. (a) Definitions. As used in this subpart, unless the context indicates otherwise...

42 CFR 423.886 - Retiree drug subsidy amounts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Retiree drug subsidy amounts. 423.886 Section 423... (CONTINUED) MEDICARE PROGRAM 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) For each...

Medicare program: changes to the hospital outpatient prospective payment system and CY 2008 payment rates, the ambulatory surgical center payment system and CY 2008 payment rates, the hospital inpatient prospective payment system and FY 2008 payment rates; and payments for graduate medical education for affiliated teaching hospitals in certain emergency situations Medicare and Medicaid programs: hospital conditions of participation; necessary provider designations of critical access hospitals. Interim and final rule with comment period.

PubMed

2007-11-27

This final rule with comment period revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system. We describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2008. In addition, the rule sets forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which the final policies of the ASC payment system apply, and other pertinent rate setting information for the CY 2008 ASC payment system. Furthermore, this final rule with comment period will make changes to the policies relating to the necessary provider designations of critical access hospitals and changes to several of the current conditions of participation requirements. The attached document also incorporates the changes to the FY 2008 hospital inpatient prospective payment system (IPPS) payment rates made as a result of the enactment of the TMA, Abstinence Education, and QI Programs Extension Act of 2007, Public Law 110-90. In addition, we are changing the provisions in our previously issued FY 2008 IPPS final rule and are establishing a new policy, retroactive to October 1, 2007, of not applying the documentation and coding adjustment to the FY 2008 hospital-specific rates for Medicare-dependent, small rural hospitals (MDHs) and sole community hospitals (SCHs). In the interim final rule with comment period in this document, we are modifying our regulations relating to graduate medical education (GME) payments made to teaching hospitals that have Medicare affiliation agreements for certain emergency situations.

24 CFR 203.436 - Claim procedure-graduated payment mortgages.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Claim procedure-graduated payment... AUTHORITIES SINGLE FAMILY MORTGAGE INSURANCE Contract Rights and Obligations Graduated Payment Mortgages § 203.436 Claim procedure—graduated payment mortgages. All of the provisions of this subpart are applicable...

24 CFR 203.436 - Claim procedure-graduated payment mortgages.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Claim procedure-graduated payment... AUTHORITIES SINGLE FAMILY MORTGAGE INSURANCE Contract Rights and Obligations Graduated Payment Mortgages § 203.436 Claim procedure—graduated payment mortgages. All of the provisions of this subpart are applicable...

24 CFR 203.436 - Claim procedure-graduated payment mortgages.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Claim procedure-graduated payment... AUTHORITIES SINGLE FAMILY MORTGAGE INSURANCE Contract Rights and Obligations Graduated Payment Mortgages § 203.436 Claim procedure—graduated payment mortgages. All of the provisions of this subpart are applicable...

24 CFR 203.436 - Claim procedure-graduated payment mortgages.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Claim procedure-graduated payment... AUTHORITIES SINGLE FAMILY MORTGAGE INSURANCE Contract Rights and Obligations Graduated Payment Mortgages § 203.436 Claim procedure—graduated payment mortgages. All of the provisions of this subpart are applicable...

24 CFR 203.436 - Claim procedure-graduated payment mortgages.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Claim procedure-graduated payment... AUTHORITIES SINGLE FAMILY MORTGAGE INSURANCE Contract Rights and Obligations Graduated Payment Mortgages § 203.436 Claim procedure—graduated payment mortgages. All of the provisions of this subpart are applicable...

22 CFR 201.66 - Side payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

22 CFR 201.66 - Side payments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

22 CFR 201.66 - Side payments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

22 CFR 201.66 - Side payments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

22 CFR 201.66 - Side payments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

7 CFR 1427.1204 - Eligible domestic users and exporters.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Cotton Competitiveness Payment Program § 1427.1204 Eligible domestic users and exporters. (a) For the... entered into an agreement with CCC to participate in the ELS Cotton Competitiveness Payment Program; or (2... Competitiveness Payment Program. (b) Payment applications must contain the documentation required by this subpart...

7 CFR 1210.328 - Duties.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., advertising or promotion, and the payment of the costs thereof with funds received pursuant to this Plan; (e... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan National Watermelon Promotion Board § 1210.328 Duties. The...

Patient Protection and Affordable Care Act; HHS notice of benefit and payment parameters for 2015. Final rule.

PubMed

2014-03-11

This final rule sets forth payment parameters and oversight provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional standards with respect to composite premiums, privacy and security of personally identifiable information, the annual open enrollment period for 2015, the actuarial value calculator, the annual limitation in cost sharing for stand-alone dental plans, the meaningful difference standard for qualified health plans offered through a Federally-facilitated Exchange, patient safety standards for issuers of qualified health plans, and the Small Business Health Options Program.

5 CFR 892.202 - Are retirees eligible for the premium conversion plan?

Code of Federal Regulations, 2010 CFR

2010-01-01

... conversion plan? 892.202 Section 892.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL FLEXIBLE BENEFITS PLAN: PRE-TAX PAYMENT OF HEALTH BENEFITS PREMIUMS Eligibility and Participation § 892.202 Are retirees eligible for the premium conversion plan? No...

5 CFR 892.201 - Who is covered by the premium conversion plan?

Code of Federal Regulations, 2010 CFR

2010-01-01

... plan? 892.201 Section 892.201 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL FLEXIBLE BENEFITS PLAN: PRE-TAX PAYMENT OF HEALTH BENEFITS PREMIUMS Eligibility and Participation § 892.201 Who is covered by the premium conversion plan? (a) All...

42 CFR 495.326 - Disallowance of FFP.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., requirements, and other undertakings described in the approved HIT planning advance planning document and HIT implementation advance planning document to the detriment of the proper and efficient operation of the Medicaid program, payment of FFP may be disallowed. In the case of a suspension of approval of a HIT planning...

24 CFR 92.207 - Eligible administrative and planning costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... planning costs. 92.207 Section 92.207 Housing and Urban Development Office of the Secretary, Department of... Prohibited Activities § 92.207 Eligible administrative and planning costs. A participating jurisdiction may expend, for payment of reasonable administrative and planning costs of the HOME program and ADDI, an...

Emerging lessons from regional and state innovation in value-based payment reform: balancing collaboration and disruptive innovation.

PubMed

Conrad, Douglas A; Grembowski, David; Hernandez, Susan E; Lau, Bernard; Marcus-Smith, Miriam

2014-09-01

In recent decades, practitioners and policymakers have turned to value-based payment initiatives to help contain spending on health care and to improve the quality of care. The Robert Wood Johnson Foundation funded 7 grantees across the country to design and implement value-based, multistakeholder payment reform projects in 6 states and 3 regions of the United States. As the external evaluator of these projects, we reviewed documents, conducted Internet searches, interviewed key stakeholders, cross-validated factual and narrative interpretation, and performed qualitative analyses to derive cross-site themes and implications for policy and practice. The nature of payment reform and its momentum closely reflects the environmental context of each project. Federal legislation such as the Patient Protection and Affordable Care Act and federal and state support for the development of the patient-centered medical home and accountable care organizations encourage value-based payment innovation, as do local market conditions for payers and providers that combine a history of collaboration with independent innovation and experimentation by individual organizations. Multistakeholder coalitions offer a useful facilitating structure for galvanizing payment reform. But to achieve the objectives of reduced cost and improved quality, multistakeholder payment innovation must overcome such barriers as incompatible information systems, the technical difficulties and transaction costs of altering existing billing and payment systems, competing stakeholder priorities, insufficient scale to bear population health risk, providers' limited experience with risk-bearing payment models, and the failure to align care delivery models with the form of payment. From the evidence adduced in this article, multistakeholder, value-based payment reform requires a trusted, widely respected "honest broker" that can convene and maintain the ongoing commitment of health plans, providers, and purchasers. Change management is complex and challenging, and coalition governance requires flexibility and stable leadership, as market conditions and stakeholder engagement and priorities shift over time. Another significant facilitator of value-based payment reform is outside investment that enables increased investment in human resources, information infrastructure, and care management by provider organizations and their collaborators. Supportive community and social service networks that enhance population health management also are important enablers of value-based payment reform. External pressure from public and private payers is fueling a "burning bridge" between the past of fee-for-service payment models and the future of payments based on value. Robust competition in local health plan and provider markets, coupled with an appropriate mix of multistakeholder governance, pressure from organized purchasers, and regulatory oversight, has the potential to spur value-based payment innovation that combines elements of "reformed" fee-for-service with bundled payments and global payments. © 2014 Milbank Memorial Fund.

42 CFR 414.900 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals... of the Act and outlines two payment methodologies applicable to drugs and biologicals covered under...

42 CFR 414.900 - Basis and scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals... of the Act and outlines two payment methodologies applicable to drugs and biologicals covered under...

Out-of-Pocket and Informal Payment Before and After the Health Transformation Plan in Iran: Evidence from Hospitals Located in Kurdistan, Iran

PubMed Central

Piroozi, Bakhtiar; Rashidian, Arash; Moradi, Ghobad; Takian, Amirhossein; Ghasri, Hooman; Ghadimi, Tayyeb

2017-01-01

Background: One of the objectives of the health transformation plan (HTP) in Iran is to reduce out-of-pocket (OOP) payments for inpatient services and eradicate informal payments. The HTP has three phases: the first phase (launched in May 5, 2014) is focused on reducing OOP payments for inpatient services; the second phase (launched in May 22, 2014) is focused on primary healthcare (PHC) and the third phase utilizes an updated relative value units for health services (launched in September 29, 2014) and is focused on the elimination of informal payments. This aim of this study was to determine the OOP payments and the frequency of informal cash payments to physicians for inpatient services before and after the HTP in Kurdistan province, Iran. Methods: This quasi-experimental study used multistage sampling method to select and evaluate 265 patients ischarged from hospitals in Kurdistan province. The study covered 3 phases (before the HTP, after the first, and third phases of the HTP). Part of the data was collected using a hospital information system form and the rest were collected using a questionnaire. Data were analyzed using Fisher exact test, logistic regression, and independent samples t test. Results: The mean OOP payments before the HTP and after the first and third phases, respectively, were US$59.4, US$17.6, and US$14.3 in hospital affiliated to the Ministry of Health and Medical Education (MoHME), US$39.6, US$33.7, and US$13.7 in hospitals affiliated to Social Security Organization (SSO), and US$153.3, US$188.7, and US$66.4 in private hospitals. In hospitals affiliated to SSO and MoHME there was a significant difference between the mean OOP payments before the HTP and after the third phase (P<.05). The percentage of informal payments to physicians in hospitals affiliated to MoHME, SSO, and private sector, respectively, were 4.5%, 8.1%, and 12.5% before the HTP, and 0.0%, 7.1%, and 10.0% after the first phase. Contrary to the time before the HTP, no informal payment was reported after the third phase. Conclusion: It seems that the implementation of the HTP has reduced the OOP payments for inpatient services and eradicated informal payments to physician in Kurdistan province. PMID:28949473

14 CFR 151.61 - Grant payments: Partial.

Code of Federal Regulations, 2012 CFR

2012-01-01

... payments: Partial. (a) Subject to the final determination of allowable project costs as provided in § 151.63 partial grant payments for project costs may be made to a sponsor upon application. Unless... partial payments to the estimated United States share of the project costs of the airport development...

14 CFR 151.61 - Grant payments: Partial.

Code of Federal Regulations, 2010 CFR

2010-01-01

... payments: Partial. (a) Subject to the final determination of allowable project costs as provided in § 151.63 partial grant payments for project costs may be made to a sponsor upon application. Unless... partial payments to the estimated United States share of the project costs of the airport development...

14 CFR 151.61 - Grant payments: Partial.

Code of Federal Regulations, 2011 CFR

2011-01-01

... payments: Partial. (a) Subject to the final determination of allowable project costs as provided in § 151.63 partial grant payments for project costs may be made to a sponsor upon application. Unless... partial payments to the estimated United States share of the project costs of the airport development...

30 CFR 250.126 - Electronic payment instructions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Electronic payment instructions. You must file all payments electronically through Pay.gov. This includes, but is not limited to, all OCS applications or filing fee payments. The Pay.gov Web site may be accessed through a link on the BSEE Offshore Web site at: http://www.bsee.gov/offshore/ homepage or...

30 CFR 250.126 - Electronic payment instructions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Electronic payment instructions. You must file all payments electronically through Pay.gov. This includes, but is not limited to, all OCS applications or filing fee payments. The Pay.gov Web site may be accessed through a link on the BSEE Offshore Web site at: http://www.bsee.gov/offshore/ homepage or...

30 CFR 250.126 - Electronic payment instructions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Electronic payment instructions. You must file all payments electronically through Pay.gov. This includes, but is not limited to, all OCS applications or filing fee payments. The Pay.gov Web site may be accessed through a link on the BSEE Offshore Web site at: http://www.bsee.gov/offshore/ homepage or...

20 CFR 408.1215 - How do you establish eligibility for Federally administered State recognition payments?

Code of Federal Regulations, 2010 CFR

2010-04-01

... Federally administered State recognition payments? 408.1215 Section 408.1215 Employees' Benefits SOCIAL... Recognition Payments § 408.1215 How do you establish eligibility for Federally administered State recognition... deemed to have filed an application for any Federally administered State recognition payments for which...

7 CFR 1437.11 - Average market price and payment factors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Average market price and payment factors. 1437.11... ASSISTANCE PROGRAM General Provisions § 1437.11 Average market price and payment factors. (a) An average... average market price by the applicable payment factor (i.e., harvested, unharvested, or prevented planting...

A Nationwide Survey of Patient Centered Medical Home Demonstration Projects

PubMed Central

Bitton, Asaf; Martin, Carina

2010-01-01

Background The patient centered medical home has received considerable attention as a potential way to improve primary care quality and limit cost growth. Little information exists that systematically compares PCMH pilot projects across the country. Design Cross-sectional key-informant interviews. Participants Leaders from existing PCMH demonstration projects with external payment reform. Measurements We used a semi-structured interview tool with the following domains: project history, organization and participants, practice requirements and selection process, medical home recognition, payment structure, practice transformation, and evaluation design. Results A total of 26 demonstrations in 18 states were interviewed. Current demonstrations include over 14,000 physicians caring for nearly 5 million patients. A majority of demonstrations are single payer, and most utilize a three component payment model (traditional fee for service, per person per month fixed payments, and bonus performance payments). The median incremental revenue per physician per year was $22,834 (range $720 to $91,146). Two major practice transformation models were identified—consultative and implementation of the chronic care model. A majority of demonstrations did not have well-developed evaluation plans. Conclusion Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1262-8) contains supplementary material, which is available to authorized users. PMID:20467907

Favorable Risk Selection in Medicare Advantage: Trends in Mortality and Plan Exits Among Nursing Home Beneficiaries

PubMed Central

Goldberg, Elizabeth M.; Trivedi, Amal N.; Mor, Vincent; Jung, Hye-Young; Rahman, Momotazur

2016-01-01

The 2003 Medicare Modernization Act (MMA) increased payments to Medicare Advantage plans and instituted a new risk-adjustment payment model to reduce plans' incentives to enroll healthier Medicare beneficiaries and avoid those with higher costs. Whether the MMA reduced risk selection remains debatable. This study uses mortality differences, nursing home utilization, and switch rates to assess whether the MMA successfully decreased risk selection from 2000 to 2012. We found no decrease in the mortality difference or adjusted difference in nursing home use between plan beneficiaries pre- and post the MMA. Among beneficiaries with nursing home use, disenrollment from Medicare Advantage plans declined from 20% to 12%, but it remained 6 times higher than the switch rate from traditional Medicare to Medicare Advantage. These findings suggest that the MMA was not associated with reductions in favorable risk selection, as measured by mortality, nursing home use, and switch rates. PMID:27516452

Are health-based payments a feasible tool for addressing risk segmentation?

PubMed

Rogal, D L; Gauthier, A K

1998-01-01

As they attempt to increase health insurance coverage and improve the efficiency of the market, researchers, policymakers, and health plan representatives have been addressing the issue of risk segmentation. Many risk assessment tools and risk-adjusted payment methodologies have been developed and demonstrated for a variety of populations and payers experiencing various market constraints. The evidence shows that risk-adjusted payments are feasible for most populations receiving acute care, while technical obstacles, political issues, and some research gaps remain.

75 FR 71799 - Medicare Program: Hospital Outpatient Prospective Payment System and CY 2011 Payment Rates...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

...The final rule with comment period in this document revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act). In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2011. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act. In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other pertinent ratesetting information for the CY 2011 ASC payment system. These changes are applicable to services furnished on or after January 1, 2011. In this document, we also are including two final rules that implement provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education (GME) and indirect medical education (IME) costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest. In the interim final rule with comment period that is included in this document, we are changing the effective date for otherwise eligible hospitals and critical access hospitals that have been reclassified from urban to rural under section 1886(d)(8)(E) of the Social Security Act and 42 CFR 412.103 to receive reasonable cost payments for anesthesia services and related care furnished by nonphysician anesthetists from cost reporting periods beginning on or after October 1, 2010, to December 2, 2010.

12 CFR 303.206 - Application for payment of principal or interest on subordinated debt.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Application for payment of principal or... CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Prompt Corrective Action § 303.206 Application... insured depository institution shall submit an application to pay principal or interest on subordinated...

7 CFR 1415.14 - Misrepresentation and violations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... participant's negligence or failure to comply with the easement terms and conditions. (c) USDA may require the... applicable law, USDA may withhold any easement payment, rental payment, or cost-share payments owing to the...

76 FR 15938 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

...; cost recovery payments, 2 hours; sector proposals, 300 hours; sector operation plans, 200 hours. Burden...; sector operations plans for approved sector proposals. Affected Public: Business or other for-profit...: National Oceanic and Atmospheric Administration (NOAA). Title: Atlantic Sea Scallop Fishery Management Plan...

Increasing the amount of payment to research subjects

PubMed Central

Resnick, DB

2014-01-01

This article discusses some ethical issues that can arise when researchers decide to increase the amount of payment offered to research subjects to boost enrollment. Would increasing the amount of payment be unfair to subjects who have already consented to participate in the study? This article considers how five different models of payment—the free market model, the wage payment model, the reimbursement model, the appreciation model, and the fair benefits model—would approach this issue. The article also considers several practical problems related to changing the amount of payment, including determining whether there is enough money in the budget to offer additional payments to subjects who have already enrolled, ascertaining how difficult it will be to re-contact subjects, and developing a plan of action for responding to subjects who find out they are receiving less money and demand an explanation. PMID:18757614

77 FR 21775 - Risk Adjustment Meeting-May 7, 2012 and May 8, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

... notice announces a meeting on the risk adjustment program, which is open to the public. The purpose of... plan average actuarial risk, calculation of payments and charges, data collection approach, and the..., calculation of payments and charges, data collection approach, and the schedule for running risk adjustment...

26 CFR 1.409A-2 - Deferral elections.

Code of Federal Regulations, 2010 CFR

2010-04-01

... not include an election as to the medium of payment (for example, an election between a payment of... provision providing for a differing treatment of such compensation may not be effective for 12 months from... (a)(13), a plan that was adopted and effective before December 31, 2007, whether written or unwritten...

31 CFR 346.8 - Payment or redemption during lifetime of owner.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., electrocardiogram, or other objective findings, so that despite medical treatment breathlessness, pain, or fatigue... any of the owner's bonds are submitted for payment to a Federal Reserve Bank or Branch or to the... individual annuity, an employees' trust, or annuity plan, as described in sections 408(a), 408(b), 401(a) and...

31 CFR 346.8 - Payment or redemption during lifetime of owner.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., electrocardiogram, or other objective findings, so that despite medical treatment breathlessness, pain, or fatigue... any of the owner's bonds are submitted for payment to a Federal Reserve Bank or Branch or to the... individual annuity, an employees' trust, or annuity plan, as described in sections 408(a), 408(b), 401(a) and...

31 CFR 346.8 - Payment or redemption during lifetime of owner.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., electrocardiogram, or other objective findings, so that despite medical treatment breathlessness, pain, or fatigue... any of the owner's bonds are submitted for payment to a Federal Reserve Bank or Branch or to the... individual annuity, an employees' trust, or annuity plan, as described in sections 408(a), 408(b), 401(a) and...

26 CFR 1.404(g)-1 - Deduction of employer liability payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

...(g)-1 Section 1.404(g)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.404(g)-1... employer. (c) Limitations, etc.—(1) Permissible expenses. A payment shall be deductible under section 404(g...

Notification: Hotline Complaint – Region 7 Compliance with Bid, Payment, and Performance Bond Requirements Outlined in Federal Acquisition Regulation (FAR) Part 28

EPA Pesticide Factsheets

June 1, 2012. In response to an anonymous hotline complaint, the OIG plans to conduct a review of Region 7’s compliance with bid, payment, and performance bond requirements outlined in Federal Acquisition Regulation (FAR) Part 28.

42 CFR 423.329 - Determination of payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

...—(1) Direct subsidy. CMS makes a direct subsidy payment for each Part D eligible beneficiary enrolled... for health status (as determined under § 423.329(b)(1)), and reduced by the base beneficiary premium for the plan (as determined under § 423.286(c) and adjusted in § 423.286(d)(1)). The direct subsidy...

42 CFR 423.329 - Determination of payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

...—(1) Direct subsidy. CMS makes a direct subsidy payment for each Part D eligible beneficiary enrolled... for health status (as determined under § 423.329(b)(1)), and reduced by the base beneficiary premium for the plan (as determined under § 423.286(c) and adjusted in § 423.286(d)(1)). The direct subsidy...

42 CFR 423.329 - Determination of payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

...—(1) Direct subsidy. CMS makes a direct subsidy payment for each Part D eligible beneficiary enrolled... for health status (as determined under § 423.329(b)(1)), and reduced by the base beneficiary premium for the plan (as determined under § 423.286(c) and adjusted in § 423.286(d)(1)). The direct subsidy...

78 FR 40271 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... care hospital length of stay. ADL Activities of daily living. AHRQ Agency for Healthcare Research and.... DHHS Department of Health and Human Services. DM Diabetes mellitus. DME Durable medical equipment. DRA... payment [Adjustment]. POC Plan of care. PRRB Provider Reimbursement Review Board. PT Physical therapy. QAP...

42 CFR 424.40 - Request for payment effective for more than one claim.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the first claim for home health services or outpatient physical therapy or speech pathology services... or outpatient physical therapy or speech pathology services furnished by the provider under that plan... for payment statement prescribed by CMS and signed by the beneficiary (or by his or her representative...

47 CFR 1.1158 - Form of payment for regulatory fees.

Code of Federal Regulations, 2012 CFR

2012-10-01

... regulatory fee payment (including a regulatory fee payment submitted with an application in the wireless radio service) made by credit card or money order must be submitted with a completed FCC Form 159...

47 CFR 1.1158 - Form of payment for regulatory fees.

Code of Federal Regulations, 2014 CFR

2014-10-01

... regulatory fee payment (including a regulatory fee payment submitted with an application in the wireless radio service) made by credit card or money order must be submitted with a completed FCC Form 159...

47 CFR 1.1158 - Form of payment for regulatory fees.

Code of Federal Regulations, 2013 CFR

2013-10-01

... regulatory fee payment (including a regulatory fee payment submitted with an application in the wireless radio service) made by credit card or money order must be submitted with a completed FCC Form 159...

42 CFR 57.1508 - Amount of interest subsidy payments; limitations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... payments will be made, and the level of such payments shall be determined by the Secretary on the basis of... consideration his analysis of the present and reasonable projected future financial ability of the applicant to... Profession Personnel § 57.1508 Amount of interest subsidy payments; limitations. The length of time for which...