The Code of Federal Regulations of the United States of AmericaU.S. Government Printing Office, 1987 The Code of Federal Regulations is the codification of the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government. |
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adjusted Administration agency agreement allowable cost amount amount in controversy ance applicable appropriate approved assets basis beneficiary benefits carrier chapter clinic coinsurance contract period cost reporting period coverage covered services deductible dialysis effective eligible enrollment entitled ESRD facility Federal filed HCFA health maintenance organization health services HMO's home health hospice care hospital's ices individual interim intermediary items or services laboratory Medi Medicaid Medicare enrollees meet ment month nished notice organiza organization outpatient paid participation party patient payment rates percent physi physical therapy physician premiums procedures prospective payment prospective payment system provider of services Public Health qualified reasonable charge reasonable cost records Redesignated at 42 reim reimbursement renal renal dialysis request requirements Secretary Sept services furnished Social Security Act Social Security Administration specified in paragraph speech pathology Standard Subpart supplier termination tient tion title XVIII
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Página 16 - ... is in the public interest because furnishing the information can be considered as primarily benefiting the general public.
Página 338 - Notwithstanding any other provisions of this title, no payment may be made under part A or part B for any expenses incurred for items or services — (1) which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member...
Página 66 - XVIII of the Act with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made, under a workmen's compensation law or plan of the United States or a State.
Página 303 - States or (B) an alien lawfully admitted for permanent residence who has resided in the United States (as...
Página 234 - ... (4) in the case of an agency or organization in any State in which State or applicable local law provides for the licensing of agencies or organizations of this nature, (A) is licensed pursuant to such law, or (B) is approved, by the agency of such State or locality responsible for licensing...
Página 135 - ... he may institute for the United States, or in the name of the United States, an action in a district court of the United States, in accordance with sections 1391 through 1393 of title 28, United States Code, for a restraining order, a preliminary or permanent injunction, or such other order as he deems appropriate.
Página 394 - The objective is that under the methods of determining costs, the costs with respect to individuals covered by the program will not be borne by individuals not so covered, and the costs with respect to individuals not so covered will not be borne by the program.
Página 520 - ... the Secretary determines to be reasonable, taking into account the range of interest rates prevailing in the private market for similar loans and the risks assumed by the United States...
Página 50 - ... did not know and could not reasonably have been expected to know that the act ordered was unlawful.
Página 89 - The standards set forth in this chapter do not apply to the handling of any claim as to which there is an indication of fraud, the presentation of a false claim, or misrepresentation on the part of the debtor or any other party having an interest in the claim, or to any claim based in whole or in part on conduct in violation of the antitrust laws.