C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 482—CONDITIONS OF PARTICIPATION FOR HOSPITALS › Subpart A—General Provisions

42 C.F.R. § 482.1

Basis and scope

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(a) Statutory basis. (1) Section 1861(e) of the Act provides that—

(i) Hospitals participating in Medicare must meet certain specified requirements; and

(ii) The Secretary may impose additional requirements if they are found necessary in the interest of the health and safety of the individuals who are furnished services in hospitals.

(2) Section 1861(f) of the Act provides that an institution participating in Medicare as a psychiatric hospital must meet certain specified requirements imposed on hospitals under section 1861(e), must be primarily engaged in providing, by or under the supervision of a physician, psychiatric services for the diagnosis and treatment of mentally ill persons, must maintain clinical records and other records that the Secretary finds necessary, and must meet staffing requirements that the Secretary finds necessary to carry out an active program of treatment for individuals who are furnished services in the hospital. A distinct part of an institution can participate as a psychiatric hospital if the institution meets the specified 1861(e) requirements and is primarily engaged in providing psychiatric services, and if the distinct part meets the records and staffing requirements that the Secretary finds necessary.

(3) Sections 1861(k) and 1902(a)(30) of the Act provide that hospitals participating in Medicare and Medicaid must have a utilization review plan that meets specified requirements.

(4) Section 1883 of the Act sets forth the requirements for hospitals that provide long term care under an agreement with the Secretary.

(5) Section 1905(a) of the Act provides that “medical assistance” (Medicaid) payments may be applied to various hospital services. Regulations interpreting those provisions specify that hospitals receiving payment under Medicaid must meet the requirements for participation in Medicare (except in the case of medical supervision of nurse-midwife services. See §§ 440.10 and 440.165 of this chapter.).

(b) Scope. Except as provided in subpart A of part 488 of this chapter, the provisions of this part serve as the basis of survey activities for the purpose of determining whether a hospital qualifies for a provider agreement under Medicare and Medicaid.

[51 FR 22042, June 17, 1986, as amended at 60 FR 50442, Sept. 29, 1995]
Notes of Decisions
Cited in 29 cases (7 in the last 5 years), 1993–2026 · leading case: United States Ex Rel. Conner v. Salina Reg'l Health Ctr., Inc., 543 F.3d 1211 (10th Cir. 2008).
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United States Ex Rel. Conner v. Salina Reg'l Health Ctr., Inc., 543 F.3d 1211 (10th Cir. 2008). · cites it 2× “See 42 C.F.R. § 482.1 (a)(5). For simplicity, we use "Medicare” to refer to participation in both programs.”
Evelyn v. v. Kings Cnty. Hosp. Ctr., 819 F. Supp. 183 (E.D.N.Y 1993). · cites it 6× “§ 1395x(e)(9) (1988) (empowering Secretary to set such standards for Medicare providers); 42 C.F.R. § 482.1 (a)(3) (1992) (hospitals participating in Medicaid program must meet standards for participation in Medicare).”
United States v. Salina Reg'l Health Ctr., Inc., 459 F. Supp. 2d 1081 (D. Kan. 2006). · cites it 3× “Conner alleges that defendant violated the following statutes and regulations: (1) 42 C.F.R. §§ 482.1 et seq.; (2) 42 U.S.C.”
NCED Mental Health, Inc. v. Kidd, 214 S.W.3d 28 (Tex. App. 2006). “See generally 42 CFR §§ 482.1 , 482.2, 482.11-482.13, 482.”
Bain v. Colbert Cnty. Nw. Alabama Health Care Auth., 233 So. 3d 945 (Ala. 2017). · cites it 2× “” 42 C.F.R. § 482.1 . For example, like Regulation 420-5-7-.”
United States Ex Rel. Ortega v. Columbia Healthcare, Inc., 240 F. Supp. 2d 8 (D.D.C. 2003). “42 C.F.R. §§ 482.1 et seq., 489.10. To participate, a healthcare entity must be in compliance with all of these.”
Hill v. Bd. of Regents of the Univ. Sys. of Georgia Et Al., 829 S.E.2d 193 (Ga. Ct. App. 2019). “" 42 CFR § 482.1 (b). Even if each Defendant could be deemed to qualify as a "hospital" within the meaning of Section 482.”
Neiberger v. Hawkins, 208 F.R.D. 301 (D. Colo. 2002). “See 42 C.F.R. § 482.1 (2). These regulations “serve as the basis of survey activities for the purpose of determining whether a hospital qualifies for a provider agreement under Medicare and Medicaid.”
Parkview Adventist Med. Ctr. v. United States Ex Rel. Dep't of Health & Human Servs., 842 F.3d 757 (1st Cir. 2016). “See also 42 C.F.R. § 482.1 . More specifically, a Medicare-participating hospital must be an institution which is primarily engaged in providing care to inpatients.”
Sylvia Galvan v. Mem'l Hermann Hosp. Sys., 476 S.W.3d 429 (Tex. 2015). “42 C.F.R. § 482.1 , .42. The hospital also refers to a guideline from the U.”
Louisa D. Reddic v. East Texas Med. Ctr. Reg'l Health Care Sys., Individually & D/B/A East Texas Med. Ctr.-Crockett, Inc., 474 S.W.3d 672 (Tex. 2015). “” 42 C.F.R. §§ 482.1 , .41, .41(c)(2). The hospital also points to- requirements in the standards of The Joint Commission — an independent organization that accredits and certifies health care organizations.”
Godwin v. Univ. of South Florida Bd. of Trs., 203 So. 3d 924 (Fla. 2d DCA 2016). “42 C.F.R. § 482.1 (b). This section was intended to specify the standards that the federal government will assess when determining whether or not a hospital will continue to be eligible to treat Medicare patients.”
Show all 29 citing cases →
— 42 C.F.R. § 482.1(a) — 1 case
Bates v. Methodist Le Bonheur Healthcare (W.D. Tenn. 2024).
— 42 C.F.R. § 482.1(b) — 1 case
Bates v. Methodist Le Bonheur Healthcare (W.D. Tenn. 2024).
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