Medicare program; aggregation of Medicare claims for administrative appeals--HCFA. Final rule

Medicare beneficiaries and, under certain circumstances, providers, physicians and other entities furnishing health care services may appeal adverse determinations regarding certain claims for benefits payable under part A and part B of Medicare. For administrative appeals at the carrier or intermediary hearing level or administrative law judge (ALJ) level and for any subsequent judicial review, the amount remaining in dispute must meet or exceed threshold amounts set by statute. Section 1869(b)(2) of the Social Security Act permits claims to be aggregated to reach the ALJ hearing threshold amounts. This final rule establishes a system of aggregation under which individual appellants have one set of requirements for aggregating claims and two or more appellants have a different set of requirements for aggregating claims.     

Medicare program; changes to the Medicare+Choice program. Health Care Financing Administration (HCFA), HHS. Final rule

The purpose of this final rule is to set forth limited changes to the Medicare+Choice regulations published in our June 26, 1998 interim final rule (63 FR 34968). Those regulations implemented section 4001 of the Balanced Budget Act of 1997 (BBA), which established the Medicare+Choice (M+C) program. This final rule addresses selected issues raised by commenters on the June 26, 1998 interim final rule where we have identified the need for changes or where we believe that clarifications are needed as soon as possible. Among these issues are provider participation procedures, beneficiary enrollment options, and several access-related issues, including initial care assessment requirements, notification requirements when specialists are terminated from an M+C plan, and several coordination of care requirements.     

Medicare program; elimination of statement of intent procedures for filing Medicare claims. Final rule

This final rule removes the written statement of intent (SOI) procedures, set forth in 42 CFR 424.45, used to extend the time for filing Medicare claims. In the absence of an SOI, providers and suppliers (and, where applicable, beneficiaries) have from 15 to 27 months (depending on the date of service) to file claims with Medicare contractors.     

Medicare program; revision of the procedures for requesting exceptions to cost limits for skilled nursing facilities and elimination of reclassifications. Department of Health and Human Services (HHS), Health Care Financing Administration (HCFA). Final rule

This final rule revises the procedures for granting exceptions to the cost limits for skilled nursing facilities (SNFs) and retains the current procedures for exceptions to the cost limits for home health agencies (HHAs). It also removes the provision allowing reclassification for all providers.     

Medicare program; suggestion program on methods to improve Medicare efficiency. Health Care Financing Administration (HCFA), HHS. Final rule with comment period

This final rule with comment period establishes a program to encourage individuals to submit suggestions that could improve the efficiency of the Medicare program. The rule implements section 203(c) of the Health Insurance Portability and Accountability Act of 1996. The intent of this rule is to encourage suggestions and to award, if we deem appropriate, monetary payments to individuals for suggestions that improve efficiency and produce monetary savings to the Medicare program.     

Medicare program; revision of the procedures for requesting exceptions to cost limits for skilled nursing facilities and elimination of reclassifications--HCFA. Proposed rule

This proposed rule would revise the procedures for granting exceptions to the cost limits for skilled nursing facilities (SNFs) and retain the current procedures for exceptions to the cost limits for home health agencies (HHAs). It also would remove the provision allowing reclassifications for all providers.     

Medicare program; revised procedures for paying claims from providers of services--HCFA. Final notice

This final notice announces the implementation of a uniform payment policy and procedures for paying providers of services under Medicare Parts A and B. The revised payment policy allows providers to elect to receive claims payments through either (1) electronic funds transfer; or (2) hard copy checks sent directly by first class mail. The procedures allow intermediaries and carriers to pay providers through direct deposits into providers' bank accounts if the providers (1) are already electronic media claims billers; (2) accept an electronic remittance notice in lieu of a paper remittance notice; and (3) request electronic funds transfer in writing. The procedures are issued in response to requests from both contractors and HCFA regional offices to implement a policy for payment methods that treats all payees uniformly.     

论迁徙自由立法的例外规定

迁徙自由原则一直以来都是国际移民法的重点原则，也是世界公认的一项基本人权，对迁徙自由权可以从一般性规定。限制性规定和保护性规定三个方面来阐述，其中后两者即例外性规定是政策制定与司法实践过程中的焦点，其目的是为了更有效地保障公民的迁徙自由权。本文通过对《公民权利和政治权利国际公约》，各国特别是美德两国关于迁徙自由权限制性，以及限制之限制规定的立法模式和立法内容的分析，给例外规定的中国化提供了借鉴，以更全面地保障中国公民的迁徙自由权。     

Medicare program; Medicare as secondary payer and Medicare recovery against third parties--HCFA. Final rule; reinstatement of regulations

This rule amends final regulations published on October 11, 1989, at 54 FR 41716 in order to replace changes that were intended to clarify policy, but have been interpreted by some readers as expressing substantive policy changes. With the exception of updated cross-references, we therefore are reissuing language that was in effect before the effective date of the October 11, 1989 final rule.     

Medicare program: revised criteria for defining a skilled nursing facility when determining spell of illness status--HCFA. Notice of HCFA ruling

This notice announces a HCFA Ruling that establishes revised criteria for defining a skilled nursing facility under section 1861(j)(1) of the Social Security Act when determing a beneficiary's spell of illness status.