42 C.F.R. § 417.546 Physicians' services and other Part B supplier services furnished under arrangements.
Title 42 - Public Health
General principle. The amount paid by an HMO or CMP for physicians' services and other Part B supplier services furnished under arrangements is an allowable cost to the extent it is reasonable. Costs are considered reasonable if they— (a) Do not exceed those that a prudent and cost-conscious buyer would incur to purchase those services; and (b) Are comparable to costs incurred for similar services furnished by similar physicians or other suppliers in the same or a similar geographic area. [50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993; 60 FR 34887, July 5, 1995; 60 FR 45372, Aug. 31, 1995]
Title 42: Public Health
PART 417—HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS
Subpart O—Medicare Payment: Cost Basis
§ 417.546 Physicians' services and other Part B supplier services furnished under arrangements.
