C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 418—HOSPICE CARE › Subpart G—Payment for Hospice Care

42 C.F.R. § 418.301

Basic rules

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(a) Medicare payment for covered hospice care is made in accordance with the method set forth in § 418.302.

(b) Medicare reimbursement to a hospice in a cap period is limited to a cap amount specified in § 418.309.

(c) The hospice may not charge a patient for services for which the patient is entitled to have payment made under Medicare or for services for which the patient would be entitled to payment, as described in § 489.21 of this chapter.

[48 FR 56026, Dec. 16, 1983, as amended at 56 FR 26919, June 12, 1991; 70 FR 70547, Nov. 22, 2005]
Notes of Decisions
Cited in 2 cases (1 in the last 5 years), 2010–2022 · leading case: Lion Health Servs., Inc. v. Sebelius, 689 F. Supp. 2d 849 (N.D. Tex. 2010).
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Lion Health Servs., Inc. v. Sebelius, 689 F. Supp. 2d 849 (N.D. Tex. 2010). “42 C.F.R. §§ 418.301 (a), 418.302(a)-(d); see 42 U.”
Gentiva Health Servs., Inc. v. Becerra, 31 F.4th 766 (D.C. Cir. 2022). “§ 1395f(i)(2); see 42 C.F.R. §§ 418.301 (b), .308(a). With respect to the aggregate cap, the Medicare statute provides that reimbursements for hospice services are capped annually: “The amount of payment made under this part for hospice care provided by (or under arrangements…”
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