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
Subpart A--GENERAL PROVISIONS
|
|
| Acceptance of a provider as a participant.
|
|
|
|
| Decision to deny an agreement.
|
|
|
|
| Effective date of agreement or approval.
|
|
|
|
| Change of ownership or leasing: Effect on provider agreement.
|
|
Subpart B--ESSENTIALS OF PROVIDER AGREEMENTS
|
|
| Specific limitations on charges.
|
|
|
|
| Special provisions applicable to prepayment requirements.
|
|
|
|
| Specific limitation on charges for services provided to certain enrollees of fee-for-service FEHB plans.
|
|
|
|
| Special responsibilities of Medicare hospitals in emergency cases.
|
|
|
|
| Special requirements concerning CHAMPUS and CHAMPVA programs.
|
|
|
|
| Special requirements concerning veterans.
|
|
|
|
| Beneficiary notice of discharge rights.
|
|
|
|
| Special capitalization requirements for HHAs.
|
|
Subpart C--ALLOWABLE CHARGES
|
|
| Allowable charges: Deductibles and coinsurance.
|
|
|
|
| Allowable charges: Blood.
|
|
|
|
| Allowable charges: Noncovered and partially covered services.
|
|
|
|
| Allowable charges: Hospitals participating in State reimbursement control systems or demonstration projects.
|
|
Subpart D--HANDLING OF INCORRECT COLLECTIONS
|
|
| Definition of incorrect collection.
|
|
|
|
| Timing and methods of handling.
|
|
|
|
| Payment of offset amounts to beneficiary or other person.
|
|
Subpart E--TERMINATION OF AGREEMENT AND REINSTATEMENT AFTER TERMINATION
|
|
| Termination by the provider.
|
|
|
|
| Exceptions to effective date of termination.
|
|
|
|
| Reinstatement after termination.
|
|
Subpart F--SURETY BOND REQUIREMENTS FOR HHAS
|
|
| Basic requirement for surety bonds.
|
|
|
|
| Requirement waived for Government-operated HHAs.
|
|
|
|
| Authorized Surety and exclusion of surety companies.
|
|
|
|
| Additional requirements of the surety bond.
|
|
|
|
| Effect of failure to obtain, maintain, and timely file a surety bond.
|
|
|
|
| Effect of payment by the Surety.
|
|
|
|
| Surety's standing to appeal Medicare determinations.
|
|
|
|
| Effect of review reversing determination.
|
|
|
|
| Effect of conditions of payment.
|
|
|
|
| Incorporation into existing provider agreements.
|
|
Subparts G-H--[RESERVED]
Subpart I--ADVANCE DIRECTIVES
|
|
| Requirements for providers.
|
|