42 U.S.C. § 1395b
Option to individuals to obtain other health insurance protection
Nothing contained in this subchapter shall be construed to preclude any State from providing, or any individual from purchasing or otherwise securing, protection against the cost of any health services.
Notes of Decisions
Cited in 19
cases, 1972–2013 · leading case: Brooks v. Blue Cross & Blue Shield of Florida, Inc., 116 F.3d 1364 (11th Cir. 1997).
Brooks v. Blue Cross & Blue Shield of Florida, Inc., 116 F.3d 1364 (11th Cir. 1997). “”); see also 42 U.S.C. § 1395b (“Nothing contained in this subchapter shall be construed to preclude any .”
Am. Hosp. Ass'n v. Otis R. Bowen, Sec'y, H.H.S., 834 F.2d 1037 (D.C. Cir. 1987). “When the PRO program first began, these reimbursements were retrospective ones, based upon the “reasonable cost” of providing medical services to Medicare beneficiaries, see 42 U.S. C. §§ 1395b; 42 U.S.C. § 1395x(v).”
Metro. Hosp. v. United States Dep't of Health & Human Servs., 712 F.3d 248 (6th Cir. 2013). “, 42 U.S.C. § 1395b- 9(c)(2)(A) (requiring the Medicare Beneficiary Ombudsman to hear complaints from “individuals entitled to benefits under [Medicare] part A,” with no indication of an intent Nos.”
Adams Nursing Home of Williamstown, Inc. v. F. David Mathews, Sec'y of Health, Educ. & Welfare, 548 F.2d 1077 (1st Cir. 1977). “42 U.S.C. § 1395b. The Secretary is authorized to issue regulations refining the meaning of “reasonable cost”; he must ensure that Medicare payments do not subsidize private patients and that private patients do not bear any of the costs of Medicare services.”
Health Care Serv. Corp. v. Califano, 466 F. Supp. 1190 (N.D. Ill. 1979). “Section 222 of the amendment, 42 U.S.C. § 1395b — 1, in part authorized the Secretary of Health, Education, and Welfare to conduct experiments related to fixed-price and performance incentive contracts “through grants to public or nonprofit private agencies, institutions, and…”
Rhode Island Hosp. v. Joseph A. Califano, Etc., 585 F.2d 1153 (1st Cir. 1978). “§ 1395x(u), is reimbursed for the “reasonable cost”, of its Medicare services, 42 U.S.C. § 1395b, from a federal trust fund channeled through a fiscal intermediary, here Blue Cross of Rhode Island.”
Alfred H. Turecamo & Frances M. Turecamo v. Comm'r of Internal Revenue, 554 F.2d 564 (2d Cir. 1977). “42 U.S.C. § 1395b. Of course, one who foregoes available Part A Basic Medicare benefits is not exempted from the required payment of the hospital insurance tax under §§ 3101(b) and 3111(b) of the Internal Revenue Code, and consequently Basic Medicare benefits are not readily…”
Black v. Am. Bankers Ins. Co., 478 S.W.2d 434 (Tex. 1972). “” Section 1803 (42 U.S.C.A. § 1395b) provides that nothing in the Act shall prevent any individual from purchasing or securing other protection against the cost of any health services.”
Coll. of Am. Pathologists v. Margaret M. Heckler, Sec'y, Dep't of Health & Human Servs., 734 F.2d 859 (D.C. Cir. 1984). “See 42 U.S.C. §§ 1395b, 1395d(a)(l) (1976). Inpatient hospital services, as set forth in the statute, include: (2) such nursing services and other related services, such use of hospital facilities, and such medical social services as are ordinarily furnished by the hospital for…”
In Re Healthback, L.L.C., 226 B.R. 464 (Bankr. W.D. Okla. 1998). “LEGAL FRAMEWORK The debtor is a home health care agency pursuant to 42 U.S.C. § 1395b and 1395d and is in the business of providing home health services to the elderly in their homes.”
Georgia Hosp. Ass'n v. Dep't of Med. Assistance, 528 F. Supp. 1348 (N.D. Ga. 1982). “The Secretary was also authorized by 42 U.S.C. § 1395b — 1(b) to grant the said waiver.”
Univ. Med. Ctr., Inc. v. Sebelius, 856 F. Supp. 2d 66 (D.D.C. 2012). “To coordinate billing by and payment to hospitals, Medicare contracts with fiscal intermediaries (usually private insurance companies) pursuant to 42 U.S.C. § 1395b. 1 Health care providers submit claims to fiscal intermediaries for services provided to Medicare Part A patients…”
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