42 C.F.R. § 421.103
Payment to providers
Providers are assigned to intermediaries in accordance with § 421.104. As the Medicare Administrative Contractors (MACs) are implemented, providers are reassigned from intermediaries to MACs in accordance with § 412.404 of this chapter.
Notes of Decisions
Cited in 12
cases, 1982–2007 · leading case: Heckler v. Cmty. Health Servs. of Crawford Cnty., Inc., 467 U.S. 51 (1984).
Heckler v. Cmty. Health Servs. of Crawford Cnty., Inc., 467 U.S. 51 (1984). “§ 1395h; 42 CFR § 421.103 (1982). If the intermediary the provider has nominated meets the Secretary's requirements, the Secretary then enters into an agreement with the intermediary to have it perform those administrative responsibilities she assigns it.”
Nat'l Ass'n of Home Health Agencies v. Richard S. Schweiker, 690 F.2d 932 (D.C. Cir. 1982). “42 C.F.R. § 421.103 (1981); 42 C.F.R. § 421.”
Deaconess Health Servs. Corp. v. Shalala, 912 F. Supp. 438 (E.D. Mo. 1995). “§ 1395h; 42 C.F.R. § 421.103 . At the close of a fiscal year, a provider of services submits a "cost report.”
Episcopal Hosp. v. Donna E. Shalala, Sec'y, Health & Human Servs., 994 F.2d 879 (D.C. Cir. 1993). “§ 1395h (1988); 42 C.F.R. § 421.103 (1992). Under Part A, Medicare beneficiaries receive coverage for 90 days of hospital inpatient services in each benefit period, as defined by the statute and regulations, plus an additional 60-day lifetime reserve.”
Delaware Cnty. Mem'l Hosp. v. Sullivan, 836 F. Supp. 238 (E.D. Pa. 1991). “The cost report is submitted to a fiscal intermediary, an agent of the Secretary of the Department of Health and Human Services (“the Secretary”). The fiscal intermediary audits the cost report to determine the amount of Medicare reimbursement for the year, then provides a…”
Grp. Health Inc. v. United States, 662 F. Supp. 753 (S.D.N.Y. 1987). “§ 1395h; 42 C.F.R. § 421.103 (1984). Under the statute and the contract that each fiscal intermediary must enter into with the Secretary, the fiscal intermediary is delegated the duties of auditing the records of the provider, determining the amount of reimbursement to be paid…”
Bio-Med. Applications of Providence, Inc. v. Heckler, 593 F. Supp. 1233 (D.D.C. 1984). “§ 1395h; 42 C.F.R. § 421.103 . The Secretary has delegated responsibility for the administration of Medicare to HCFA.”
Good Samaritan Hosp. Reg'l Med. Ctr. v. Shalala, 85 F.3d 1057 (2d Cir. 1996). “§ 1395h; 42 C.F.R. § 421.103 . A provider seeking reimbursement must file an annual cost report with its fiscal intermediary.”
Anaheim Mem'l Hosp. v. Shalala, 130 F.3d 845 (9th Cir. 1997). “§ 1395h; 42 C.F.R. § 421.103 (1996). Reimbursement to a provider is normally handled by a “fiscal intermediary.”
Acadian Homecare, L.L.C. v. Leavitt, 513 F. Supp. 2d 684 (W.D. La. 2007). “§ 1395h; 42 C.F.R. § 421.103 . Under Medicare Part A, home health agency providers are required to file a cost report with their intermediaries at the end of the fiscal year which reflects actual costs incurred.”
Acadian Homecare LLC v. Leavitt, 513 F. Supp. 2d 684 (W.D. La. 2007). “§ 1395h; 42 C.F.R. § 421.103 . Under Medicare Part A, home health agency providers are required to file a cost report with their intermediaries at the end of the fiscal year which reflects actual costs incurred.”
Dyna Care Home Health, Inc. v. Shalala, 35 F. Supp. 2d 1096 (N.D. Ill. 1999). “§ 1395h; 42 C.F.R. §§ 421.103 ; 413.20; 413.60; 405.”
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