42 C.F.R. PART 447--PAYMENTS FOR SERVICES
TITLE 42--Public Health
CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
SUBCHAPTER C--MEDICAL ASSISTANCE PROGRAMS
PART 447--PAYMENTS FOR SERVICES
Subpart A--PAYMENTS: GENERAL PROVISIONS
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| Prohibition against reassignment of provider claims.
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| Acceptance of State payment as payment in full.
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| Provider restrictions: State plan requirements.
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| Reduction of payments to providers.
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| Direct payments to certain recipients for physicians' or dentists' services.
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| Withholding the Federal share of payments to Medicaid providers to recover Medicare overpayments.
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| Withholding Medicare payments to recover Medicaid overpayments.
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| Payments for reserving beds in institutions.
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| Timely claims payment by MCOs.
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| Cost sharing: Basis and purpose.
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| Requirements and options.
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| Minimum and maximum income-related charges.
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| Applicability; specification; multiple charges.
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| Maximum allowable charges.
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| Restrictions on payments to providers.
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| Payments to prepaid capitation organizations.
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| FFP: Conditions relating to cost sharing.
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| Cost-sharing requirements for services furnished by MCOs.
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| Options for claiming FFP payment for section 1920A presumptive eligibility medical assistance payments.
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Subpart B--PAYMENT METHODS: GENERAL PROVISIONS
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| Documentation of payment rates.
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| Encouragement of provider participation.
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| Public notice of changes in Statewide methods and standards for setting payment rates.
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Subpart C--PAYMENT FOR INPATIENT HOSPITAL AND LONG-TERM CARE FACILITY SERVICES
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| Procedures for CMS action on assurances and State plan amendments.
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| FFP: Conditions relating to institutional reimbursement.
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| Upper limits based on customary charges.
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| Inpatient services: Application of upper payment limits.
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| Hospital providers of NF services (swing-bed hospitals).
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Subpart D--[RESERVED]
Subpart E--PAYMENT ADJUSTMENTS FOR HOSPITALS THAT SERVE A DISPROPORTIONATE NUMBER OF LOW-INCOME PATIENTS
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| Limitations on aggregate payments for disproportionate share hospitals for the period January 1, 1992 through September 30, 1992.
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| Limitations on aggregate payments for disproportionate share hospitals beginning October 1, 1992.
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| State disproportionate share hospital allotments.
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Subpart F--PAYMENT METHODS FOR OTHER INSTITUTIONAL AND NONINSTITUTIONAL SERVICES
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| Adherence to upper limits; FFP.
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| Outpatient hospital and clinic services: Application of upper payment limits.
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| Other inpatient and outpatient facility services: Upper limits of payment.
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| Drugs: Aggregate upper limits of payment.
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| Upper limits for multiple source drugs.
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| State plan requirements, findings and assurances.
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| Upper limits for drugs furnished as part of services.
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| Upper limits of payment: Nonrisk contract.
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| Services furnished by rural health clinics.
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Subparts G-H--[RESERVED]
Subpart I--PAYMENT FOR OUTPATIENT PRESCRIPTION DRUGS UNDER DRUG REBATE AGREEMENTS
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| Manufacturer reporting requirements.
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