42 C.F.R. PART 489--PROVIDER AGREEMENTS AND SUPPLIER APPROVAL


TITLE 42--Public Health

CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBCHAPTER G--STANDARDS AND CERTIFICATION

PART 489--PROVIDER AGREEMENTS AND SUPPLIER APPROVAL

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Subpart A--GENERAL PROVISIONS

�489.1
Statutory basis.
�489.2
Scope of part.
�489.3
Definitions.
�489.10
Basic requirements.
�489.11
Acceptance of a provider as a participant.
�489.12
Decision to deny an agreement.
�489.13
Effective date of agreement or approval.
�489.18
Change of ownership or leasing: Effect on provider agreement.
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Subpart B--ESSENTIALS OF PROVIDER AGREEMENTS

�489.20
Basic commitments.
�489.21
Specific limitations on charges.
�489.22
Special provisions applicable to prepayment requirements.
�489.23
Specific limitation on charges for services provided to certain enrollees of fee-for-service FEHB plans.
�489.24
Special responsibilities of Medicare hospitals in emergency cases.
�489.25
Special requirements concerning CHAMPUS and CHAMPVA programs.
�489.26
Special requirements concerning veterans.
�489.27
Beneficiary notice of discharge rights.
�489.28
Special capitalization requirements for HHAs.
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Subpart C--ALLOWABLE CHARGES

�489.30
Allowable charges: Deductibles and coinsurance.
�489.31
Allowable charges: Blood.
�489.32
Allowable charges: Noncovered and partially covered services.
�489.34
Allowable charges: Hospitals participating in State reimbursement control systems or demonstration projects.
�489.35
Notice to intermediary.
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Subpart D--HANDLING OF INCORRECT COLLECTIONS

�489.40
Definition of incorrect collection.
�489.41
Timing and methods of handling.
�489.42
Payment of offset amounts to beneficiary or other person.
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Subpart E--TERMINATION OF AGREEMENT AND REINSTATEMENT AFTER TERMINATION

�489.52
Termination by the provider.
�489.53
Termination by CMS.
�489.54
Termination by the OIG.
�489.55
Exceptions to effective date of termination.
�489.57
Reinstatement after termination.
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Subpart F--SURETY BOND REQUIREMENTS FOR HHAS

�489.60
Definitions.
�489.61
Basic requirement for surety bonds.
�489.62
Requirement waived for Government-operated HHAs.
�489.63
Parties to the bond.
�489.64
Authorized Surety and exclusion of surety companies.
�489.65
Amount of the bond.
�489.66
Additional requirements of the surety bond.
�489.67
Term and type of bond.
�489.68
Effect of failure to obtain, maintain, and timely file a surety bond.
�489.69
Evidence of compliance.
�489.70
Effect of payment by the Surety.
�489.71
Surety's standing to appeal Medicare determinations.
�489.72
Effect of review reversing determination.
�489.73
Effect of conditions of payment.
�489.74
Incorporation into existing provider agreements.
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Subparts G-H--[RESERVED]

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Subpart I--ADVANCE DIRECTIVES

�489.100
Definition.
�489.102
Requirements for providers.
�489.104
Effective dates.
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