Upper limits for drugs furnished as part of services. Identification of inhalation, infusion, instilled, implanted, or injectable drugs (5i drugs).Įxclusion from best price of certain sales at a nominal price.ĭrugs: Aggregate upper limits of payment. Primary care services furnished by physicians with a specified specialty or subspecialty.Īvailability of Federal financial participation (FFP).ĭetermination of average manufacturer price. Payments for Primary Care Services Furnished by Physicians Services furnished by rural health clinics. Upper limits of payment: Nonrisk contract. Other inpatient and outpatient facility services: Upper limits of payment. Other Inpatient and Outpatient Facilities Outpatient hospital and clinic services: Application of upper payment limits. Payment Methods for Other Institutional and Noninstitutional Services State disproportionate share hospital allotments. Limitations on aggregate payments for disproportionate share hospitals beginning October 1, 1992. Limitations on aggregate payments for disproportionate share hospitals for the period Januthrough September 30, 1992. Hospital-specific disproportionate share hospital payment limit: Determination of individuals without health insurance or other third party coverage. Medicaid disproportionate share hospital (DSH) allotment reductions. Payment Adjustments for Hospitals That Serve a Disproportionate Number of Low-Income Patients Hospital providers of NF services (swing-bed hospitals). Inpatient services: Application of upper payment limits. Procedures for CMS action on assurances and State plan amendments.įFP: Conditions relating to institutional reimbursement. Payment for Inpatient Hospital and Long-Term Care Facility Services Public notice of changes in Statewide methods and standards for setting payment rates. Medicaid provider participation and public process to inform access to care. Options for claiming FFP payment for section 1920A presumptive eligibility medical assistance payments.įFP: Conditions related to pending investigations of credible allegations of fraud against the Medicaid program.ĭocumentation of access to care and service payment rates. Limitations on premiums and cost sharing.īeneficiary and public notice requirements. Premiums and cost sharing: Basis and purpose.Ĭost sharing for services furnished in a hospital emergency department. Payments for reserving beds in institutions. Withholding Medicare payments to recover Medicaid overpayments. Withholding the Federal share of payments to Medicaid providers to recover Medicare overpayments. Prohibition on payment for provider-preventable conditions. Provider restrictions: State plan requirements.ĭirect payments to certain beneficiaries for physicians' or dentists' services. ![]() ![]() Prohibition against reassignment of provider claims.Īcceptance of State payment as payment in full.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |