C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 447—PAYMENTS FOR SERVICES › Subpart C—Payment for Inpatient Hospital and Long-Term Care Facility Services

42 C.F.R. § 447.251

Definitions

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For the purposes of this subpart—

Long-term care facility services means intermediate care facility services for Individuals with Intellectual Disabilities (ICF/IID) and nursing facility (NF) services.

Provider means an institution that furnishes inpatient hospital services or an institution that furnishes long-term care facility services.

[46 FR 47971, Sept. 30, 1981, as amended at 54 FR 5359, Feb. 2, 1989; 56 FR 48867, Sept. 26, 1991]
Notes of Decisions
Cited in 3 cases, 1985–1992 · leading case: Geriatrics, Inc. v. Colorado Dep't of Soc. Servs., 712 P.2d 1035 (Colo. Ct. App. 1985).
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Geriatrics, Inc. v. Colorado Dep't of Soc. Servs., 712 P.2d 1035 (Colo. Ct. App. 1985). “42 C.F.R. §§ 447.251 and 447.273 (1980). These regulations provided for the establishment of a system that contemplates reimbursement of a provider’s actual cost in full: “Payment rates must not be set lower than rates that the agency reasonably finds to be adequate to reimburse…”
United Cerebral Palsy Associations of New York State, Inc. v. Cuomo, 783 F. Supp. 43 (N.D.N.Y. 1992). “Whenever the Medicaid agency makes a change in its methods and standards, but not less often than annually, the agency must make the following findings: (1) Payment rates, (i) The Medicaid agency pays for inpatient hospital services and long-term care facility [which includes…”
United Cerebral Palsy Associations v. Cuomo, 783 F. Supp. 43 (N.D.N.Y. 1992). “(i) The Medicaid agency pays for inpatient hospital services and longterm care facility [which includes ICFs, see 42 C.F.R. § 447.251 ] services through the use of rates that are reasonable and adequate to meet the costs that must be incurred by efficiently and economically…”
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