(a) Bad debts. An additional payment is made to each hospital in accordance with § 413.89 of this chapter for bad debts attributable to deductible and coinsurance amounts related to covered services received by beneficiaries.
(b) Administration of blood clotting factor. For discharges occurring on or after June 19, 1990, and before October 1, 1994, and for discharges occurring on or after October 1, 1997, an additional payment is made to a hospital for each unit of blood clotting factor furnished to a Medicare inpatient who is a hemophiliac. For discharges occurring on or after October 1, 2005, the additional payment is made based on the average sales price methodology specified in subpart K, part 414 of this chapter and the furnishing fee specified in § 410.63 of this subchapter.
(c) QIO reimbursement for cost of sending requested patient records to the QIO. An additional payment is made to a hospital in accordance with § 476.78 of this chapter for the costs of sending requested patient records to the QIO in electronic format, by facsimile, or by photocopying and mailing.
[50 FR 12741, Mar. 29, 1985, as amended at 51 FR 34793, Sept. 30, 1986; 55 FR 15175, Apr. 20, 1990; 56 FR 43448, Aug. 30, 1991; 57 FR 39825, Sept. 1, 1992; 57 FR 47787, Oct. 20, 1992; 58 FR 46339, Sept. 1, 1993; 62 FR 46030, Aug. 29, 1997; 68 FR 67960, Dec. 5, 2003; 70 FR 47486, Aug. 12, 2005; 85 FR 59022, Sept. 18, 2020]
Notes of Decisions
Battle Creek Health Sys. v. Leavitt, 498 F.3d 401 (6th Cir. 2007).
· cites it 2× “42 C.F.R. § 412.115 (a). The regulations pertaining to Medicare declare that amounts due to providers from other parties that providers cannot recover are generally not reimbursable under the Medicare program because these bad debts are deemed “deductions from revenue and are…”
Kidney Ctr Hlywd v. Shalala, Donna E., 133 F.3d 78 (D.C. Cir. 1998).
“See 42 C.F.R. § 412.115 (a) (1996). The Secretary counters that the section of the Medicare statute creating the Part A prospective, payment system, 42 U.”
Lakeland Reg'l Health Sys. v. Sebelius, 958 F. Supp. 2d 1 (D.D.C. 2013).
“§ 1395x(v)(1)(A); 42 C.F.R. §§ 412.115 (a), 413.89(a, d). The regulations governing bad debt reimbursement were written to incentivize providers to practice strong and efficient collection efforts before seeking bad debt reimbursement from the Medicare program: A bad debt must…”
Battle Creek Health Sys. v. Thompson, 423 F. Supp. 2d 755 (W.D. Mich. 2006).
“However, Service providers receive reimbursement for “bad debts,” as defined at 42 C.F.R. § 412.115 (a): [Ajmounts considered to be uncollectible from accounts and notes receivable that were created or acquired in providing services.”
Detroit Receiving Hosp. v. Leavitt, 561 F. Supp. 2d 795 (E.D. Mich. 2008).
“42 C.F.R. §§ 412.115 (a), 413.89. The Medicare deductible is the annual sum that a beneficiary must pay before Medicare coverage becomes effective.”
Battle Creek Health Sys. v. Leavitt (6th Cir. 2007).
· cites it 2× “42 C.F.R. § 412.115 (a). The regulations pertaining to Medicare declare that amounts due to providers from other parties that providers cannot recover are generally not reimbursable under the Medicare program because these bad debts are deemed “deductions from revenue and are…”
Vitality Rehab, Inc. v. Sebelius, 641 F. Supp. 2d 984 (C.D. Cal. 2009).
“2d at 108 (citing 42 C.F.R. § 412.115 ). The Court finds — as the Abington court did — that based on these reasons, the Secretary’s decision that the bad debt provisions do not apply to services for which Medicare payment is based on a fee schedule methodology “is a reasonable…”
— 42 C.F.R. § 412.115(a) — 1 case
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