42 C.F.R. § 1000.10 General definitions.
Title 42 - Public Health
In this chapter, unless the context indicates otherwise— Act means the Social Security Act, and titles referred to are titles of that Act. Administrator means the Administrator, Centers for Medicare & Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA). Beneficiary means any individual eligible to have benefits paid to him or her, or on his or her behalf, under Medicare or any State health care program. CFR stands for Code of Federal Regulations. CMS stands for Centers for Medicare & Medicaid Services, formerly the Health Care Financing Administration (HCFA). Department means the Department of Health and Human Services (HHS), formerly the Department of Health, Education, and Welfare. Directly, as used in the definition of “furnished” in this section, means the provision of items and services by individuals or entities (including items and services provided by them, but manufactured, ordered or prescribed by another individual or entity) who submit claims to Medicare, Medicaid or other Federal health care programs. ESRD stands for end-stage renal disease. FR stands for Furnished refers to items or services provided or supplied, directly or indirectly, by any individual or entity. This includes items and services manufactured, distributed or otherwise provided by individuals or entities that do not directly submit claims to Medicare, Medicaid or other Federal health care programs, but that supply items or services to providers, practitioners or suppliers who submit claims to these programs for such items or services. HHS stands for the Department of Health and Human Services. HHA stands for home health agency. HMO stands for health maintenance organization. ICF stands for intermediate care facility. Indirectly, as used in the definition of “furnished” in this section, means the provision of items and services manufactured, distributed or otherwise supplied by individuals or entities who do not directly submit claims to Medicare, Medicaid or other Federal health care programs, but that provide items and services to providers, practitioners or suppliers who submit claims to these programs for such items and services. This term does not include individuals and entities that submit claims directly to these programs for items and services ordered or prescribed by another individual or entity. Inspector General means the Inspector General for Health and Human Services. Medicaid means medical assistance provided under a State plan approved under Title XIX of the Act. Medicare means the health insurance program for the aged and disabled under Title XVIII of the Act. OIG means the Office of Inspector General within HHS. QIO stands for Utilization and Quality Control Quality Improvement Organization. Secretary means the Secretary of Health and Human Services. SNF stands for skilled nursing facility. Social security benefits means monthly cash benefits payable under section 202 or 223 of the Act. SSA stands for Social Security Administration. United States means the fifty States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. U.S.C. stands for United States Code. [51 FR 34766, Sept. 30, 1986 as amended at 57 FR 3329, Jan. 29, 1992; 63 FR 46685, Sept. 2, 1998; 66 FR 39452, July 31, 2001]
Title 42: Public Health
PART 1000—INTRODUCTION; GENERAL DEFINITIONS
Subpart B—Definitions
§ 1000.10 General definitions.
