42 C.F.R. § 440.10
Inpatient hospital services, other than services in an institution for mental diseases
(a) Inpatient hospital services means services that—
(1) Are ordinarily furnished in a hospital for the care and treatment of inpatients;
(2) Are furnished under the direction of a physician or dentist; and
(3) Are furnished in an institution that—
(i) Is maintained primarily for the care and treatment of patients with disorders other than mental diseases;
(ii) Is licensed or formally approved as a hospital by an officially designated authority for State standard-setting;
(iii) Meets the requirements for participation in Medicare as a hospital; and
(iv) Has in effect a utilization review plan, applicable to all Medicaid patients, that meets the requirements of § 482.30 of this chapter, unless a waiver has been granted by the Secretary.
(b) Inpatient hospital services do not include SNF and ICF services furnished by a hospital with a swing-bed approval.
Notes of Decisions
Cited in 14
cases, 1980–2013 · leading case: Arizona Health Care Cost Containment Sys. v. McClellan, 508 F.3d 1243 (9th Cir. 2007).
Arizona Health Care Cost Containment Sys. v. McClellan, 508 F.3d 1243 (9th Cir. 2007). “These services are referred to in regulation at 42 CFR 440.10 (“Inpatient hospital services”) and 42 CFR 440.”
McRae v. Califano, 491 F. Supp. 630 (E.D.N.Y 1980). “42 C.F.R. § 440.10 . The mandatory physician’s services — whether furnished in office, home, hospital or elsewhere — means services provided within the scope of practice of medicine or osteopathy as defined by state law by or under the personal supervision of an individual…”
Addison Gilbert Hosp. v. Rate Setting Comm'n, 390 Mass. 17 (Mass. 1983). “7 Our analysis of inpatient hospital services must begin with Federal Medicaid regulation 42 C.F.R. § 440.10 (1981), which defines inpatient hospital services to be those services which “are ordinarily furnished in a hospital for the care and treatment of an inpatient,” and are…”
Eye & Ear Hosp. v. Commonwealth, 514 A.2d 976 (Pa. Commw. Ct. 1986). “” See 42 C.F.R. §§440.10 (a)(3)(ii), 440.20(a)(3)(i).”
Massachusetts Eye & Ear Infirmary v. Comm'r of Div. of Med. Assistance, 705 N.E.2d 592 (Mass. 1999). “” 42 C.F.R. § 440.10 (a). “Federal regulations, in contrast, define “[o]utpatient” as “a patient of an organized medical facility, or distinct part of that facility who is expected by the facility to receive and who does receive professional services for less than a 24-hour…”
Leocata Ex Rel. Gilbride v. Wilson-Coker, 343 F. Supp. 2d 144 (D. Conn. 2004). “A "nursing facility" is defined as an institution which (1) is primarily engaged in providing to residents (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled,…”
Warr v. Horsley, 705 F. Supp. 540 (M.D. Ala. 1989). “Mandatory services consist of inpatient hospital services, outpatient hospital services, other laboratory and X-ray services, skilled nursing facility services, physician services furnished by a physician, and nurse-midwife services.”
Leocata v. Wilson-Coker, 343 F. Supp. 2d 144 (D. Conn. 2004). “§§ 1396d(c), (d), (h), and 1396r; see also 42 C.F.R. §§ 440.10 (a)(3)(iii), 440.150(a)(3), 441.”
North Dakota Ex Rel. Olson v. Centers for Medicare & Medicaid Servs., 403 F.3d 537 (8th Cir. 2005). “According to the memorandum, "[r]eferred services, provided through a contractual arrangement, can also be considered provided 'through an IHS facility' and reimbursed at the 100 percent FMAP rate as long as these are services that could be provided as a 'facility service,' -3-…”
Ellenbecker v. Centers for Medicare & Medicaid Servs., 335 F. Supp. 2d 999 (D.S.D. 2003). “These services are referred to in regulation at 42 CFR 440.10 (“Inpatient hospital services”) and 42 CFR 440.”
North Dakota Ex Rel. Olson v. Centers for Medicare & Medicaid Servs., 286 F. Supp. 2d 1080 (D.N.D. 2003). “These services are referred to in regulation at 42 CFR 440.10 (“Inpatient hospital services”) and 42 CFR 440.”
Nix v. Dep't of Soc. & Health Servs., 256 P.3d 1259 (Wash. Ct. App. 2011). “42 C.F.R. §§ 440.10 , .50, .70. And, as the Department points out, the *917 lack of a required service is “fatal” to a diagnosis discrimination claim.”
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