Medicare program; criteria and standards for evaluating intermediary and carrier performance during FY 1995--HCFA. General notice with comment period

This notice describes the criteria and standards to be used for evaluating the performance of fiscal intermediaries and carriers in the administration of the Medicare program beginning October 1, 1994. The results of these evaluations are considered whenever HCFA enters into, renews, or terminates an intermediary agreement or carrier contract or takes other contract actions (for example, assigning or reassigning providers of services to an intermediary or designating regional or national intermediaries). This notice is published in accordance with sections 1816(f) and 1842(b)(2) of the Social Security Act. We are publishing for public comment in the Federal Register those criteria and standards against which we evaluate intermediaries and carriers.     

Criteria and standards for evaluating intermediary and carrier performance--HCFA. General notice with comment period

This notice describes the criteria and standards to be used for evaluating the performance of fiscal intermediaries and carriers in the administration of the Medicare program beginning October 1, 1990. The results of these evaluations are considered whenever HCFA enters into, renews, or terminates an intermediary agreement or carrier contract or takes other contract actions; assigns or reassigns providers of services to an intermediary; or designates regional or national intermediaries. This notice is published in accordance with sections 1816(f) and 1842(b)(2) of the Social Security Act, which requires us to publish for public comment in the Federal Register those criteria and standards against which we evaluate intermediaries and carriers.     

Medicare program; criteria and standards for evaluating intermediary and carrier performance during FY 1993--HCFA. General notice with comment period

This notice describes the criteria and standards to be used for evaluating the performance of fiscal intermediaries and carriers in the administration of the Medicare program beginning October 1, 1992. The results of these evaluations are considered whenever HCFA enters into, renews, or terminates an intermediary agreement or carrier contract or takes other contract actions (e.g., assigning or reassigning providers of services to an intermediary, designating regional or national intermediaries, etc.). This notice is published in accordance with sections 1816(f) and 1842(b)(2) of the Social Security Act. We are publishing for public comment in the Federal Register those criteria and standards against which we evaluate intermediaries and carriers.     

Medicare program; criteria and standards for evaluating intermediary and carrier performance--HCFA. General notice with comment period

This notice describes the criteria and standards to be used for evaluating the performance of fiscal intermediaries and carriers in the administration of the Medicare program beginning October 1, 1991. The results of these evaluations are considered whenever HCFA enters into, renews, or terminates an intermediary agreement or carrier contract or takes other contract actions (e.g., assigning or reassigning providers of services to an intermediary; or designating regional or national intermediaries, etc.). This notice is published in accordance with sections 1816(f) and 1842(b)(2) of the Social Security Act, which require us to publish for public comment in the Federal Register whose criteria and standards against which we evaluate intermediaries and carriers.     

Criteria and standards for evaluating intermediary and carrier performance--HCFA. General notice with comment period

This notice describes the criteria and standards to be used for evaluating the performance of fiscal intermediaries and carriers in the administration of the Medicare program beginning June 1, 1990. The results of these evaluations are considered whenever HCFA enters into, renews, or terminates an intermediary or carrier agreement or takes other contract actions; assigns or reassigns providers of services to an intermediary; or designates regional or national intermediaries. This notice is published in accordance with sections 1816(f) and 1842(b)(2) of the Social Security Act, which requires us to publish for public comment in the Federal Register those criteria and standards against which we evaluate intermediaries and carriers.     

Medicare program: revisions to criteria and standards for evaluating intermediaries and carriers--HCFA. Final rule

This rule issues technical amendments to Medicare regulations intended to simplify and improve our system for evaluating the performance of fiscal intermediaries and carriers in the administration of the Medicare program. Currently, we evaluate intermediaries using performance criteria and standards announced in an annual notice in the Federal Register. We are clarifying the methodology for establishing these criteria and standards. For consistency, we establish comparable regulation requirements for the evaluation of carrier performance. These revisions are published in accordance with sections 1816(f) and 1842(b)(2) of the Social Security Act which require us to develop standards, criteria, and procedures to evaluate an intermediary's or carrier's overall performance.     

Medicare program: data, standards, and methodology used to establish fiscal year 1994 budgets for fiscal intermediaries and carriers--HCFA. Final notice

This notice is published in accordance with sections 1816(c)(1) and 1842(c)(1) of the Social Security Act which require us to publish the final data, standards, and methodology used to establish budgets for Medicare intermediaries and carriers. In this notice, we respond to the comments received in response to our notice of October 5, 1993 and we announce the adoption of the proposed data, standards, and methodology that we used to establish the Medicare fiscal intermediary and carrier budgets for fiscal year (FY) 1994, beginning October 1, 1993, as final and without revision.     

Medicare program; data, standards and methodology used to establish fiscal year 1992 budgets for fiscal intermediaries and carriers--HCFA. Final notice

This notice is published in accordance with sections 1816(c)(1) and 1842(c)(1) of the Social Security Act which require us to publish the final data, standards and methodology used to establish budgets for Medicare intermediaries and carriers. It announces that we are adopting as final without revision proposed data, standards, and methodology used to establish Medicare fiscal intermediary and carrier budgets for the fiscal year (FY) 1992, beginning October 1, 1991. It also contains our response to public comments on the proposal.     

Medicare program: data, standards and methodology used to establish fiscal year 1993 budgets for fiscal intermediaries and carriers--HCFA. Final notice

This notice is published in accordance with sections 1816(c)(1) and 1842(c)(1) of the Social Security Act which requires us to publish the final data, standards and methodology used to establish budgets for Medicare intermediaries and carriers. It announces that we are adopting as final, and responds to comments about, the data, standards, and methodology we proposed to use to establish Medicare fiscal intermediary and carrier budgets for the fiscal year (FY) 1993, beginning October 1, 1992.     

Medicare program; criteria and standards for evaluating common working file hosts--HCFA. General notice with comment period

This notice describes the criteria and standards to be used for evaluating the performance of Common Working File (CWF) hosts in the administration of the Medicare program, for the current evaluation period beginning June 1, 1991. The results of these evaluations will be considered whenever the Health Care Financing Administration enters into, renews/extends, or terminates a Medicare carrier contract which provides for the performance of CWF host services. Since these services are currently performed by Medicare carriers, this notice is published in accordance with section 1842(b)(2) of the Social Security Act which requires us to publish for public comment those criteria and standards against which we evaluate Medicare carriers.     

Medicare program; criteria and standards for evaluating intermediary and carrier performance: millennium compliance--HCFA. General notice with comment period

This notice revises the criteria and standards to be used for evaluating the performance of fiscal intermediaries and carriers in the administration of the Medicare program. This revision establishes a performance standard requiring these contractors to meet requirements for millennium compliance. We require contractors to certify that they have made all necessary system(s) changes and have tested those systems in accordance with HCFA guidelines.     

Medicare program; Medicare integrity program, intermediary and carrier functions, and conflict of interest requirements--HCFA. Proposed rule

This proposed rule would implement section 1893 of the Social Security Act (the Act) by establishing the Medicare integrity program (MIP) to carry out Medicare program integrity activities that are funded from the Medicare Trust Funds. Section 1893 expands our contracting authority to allow us to contract with "eligible entities" to perform Medicare program integrity activities. These activities include review of provider and supplier activities, including medical, fraud, and utilization review: cost report audits; Medicare secondary payer determinations; education of providers, suppliers, beneficiaries, and other persons regarding payment integrity and benefit quality assurance issues; and developing and updating a list of durable medical equipment items that are subject to prior authorization. This proposed rule would set forth the definition of eligible entities, services to be procured, competitive requirements based on Federal acquisition regulations and exceptions (guidelines for automatic renewal), procedures for identification, evaluation, and resolution of conflicts of interest, and limitations on contractor liability. In addition, this proposed rule would bring certain sections of the Medicare regulations concerning fiscal intermediaries and carriers into conformity with the Act. The rule would distinguish between those functions that the statute requires be included in agreements with intermediaries and those that may be included in the agreements. It would also provide that some or all of the listed functions may be included in carrier contracts. Currently all these functions are mandatory for carrier contracts. These changes would give us the flexibility to transfer functions from one intermediary or carrier to another or to otherwise limit the functions an intermediary or carrier performs if we determine that to do so would result in more effective and efficient program administration.     

滚珠合同可否构成侵权责任

滚珠合同是从格式合同变迁而来,合同法律制度对格式合同规定了不利提供方解释原则。在滚珠合同中,运营商一头连接增值商,一头连结消费者,一方面为消费者提供信息服务网站,并且按时间或者按信息流量代理增值商收取费用;另一方面为增值商提供客源,并且按照代收金额分取固定比例的费用,实际上就是中介人。所以,当增值商违法时,增值商须承担法律责任,而作为中介人的运营商也应按照我国《注册会计师法》和《律师法》等法律精神,对损失承担连带责任。     

Medicare program; criteria and standards for evaluating intermediary and carrier performance during FY 1994--HCFA. General notice

In the September 30, 1993 issue of the Federal Register, we published a general notice with comment period describing the criteria and standards for evaluating intermediary and carrier performance in administering the Medicare program during FY 1994. This notice amends that document to require that contractors certify the accuracy and completeness of the information submitted to HCFA with respect to the evaluation process.     

From gatekeepers to publishers: Liability of internet intermediaries in India for hosting defamatory content

This article aims to analyse the liability of Internet intermediaries in India for hosting defamatory content. In the absence of any statutory law relating to online defamation, the courts in India have had to rely upon comparable developments in the United Kingdom to define the contours of liability of the intermediaries for facilitating the publication of defamatory content on the Internet. However, affixing liability on intermediaries in the absence of similar statutory immunities provided to them under the UK law may prove prejudicial to the intermediaries. Therefore, this article argues that India should enact a comprehensive law to statutorily limit the grounds on which liability may be imposed on Internet intermediaries for hosting online defamatory content. This article further argues that India should adopt and codify the ‘notice and notice plus’ approach to intermediary liability as it ensures that intermediaries are not held liable as publishers for hosting the defamatory content, but in the meantime are also encouraged to take active steps to ensure effective justice to the victims of online defamation.     

Medicare program; durable medical equipment regional carrier service areas and related matters. Final rule

This final rule provides a mechanism for us to expeditiously make changes to the durable medical equipment regional carrier (DMERC) service area boundaries without notice and comment rulemaking. Through this mechanism, we can change the geographical boundaries served by the regional contractors that process durable medical equipment claims through issuance of a Federal Register notice and make other minor changes in the contract administration of the DMERCs. The mechanism provides a method for increasing or decreasing the number of DMERCs, changing the boundaries of DMERCs based on criteria other than the boundaries of the Common Working File sectors, and awarding new contractors to perform statistical analysis or maintain the national supplier clearinghouse. We will publish these changes and their justifications in a Federal Register notice, rather than through notice and comment rulemaking. Although we may change the number and configuration of regional carriers, we are not altering the criteria and factors that we use in awarding contracts. Through this final rule, we are improving the contracting process so that we can swiftly meet the challenges of the changing healthcare industry and address the changing needs of beneficiaries, suppliers, and the Medicare program.     

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.     

Medicare program; data, standards and methodology used to establish budgets for fiscal intermediaries and carriers--HCFA. Final notice

This notice announces that we are adopting as final without revision previously published proposed data, standards and methodology to establish fiscal intermediary and carrier budgets for the fiscal year beginning October 1, 1990.     

Special report on reimbursement. Medicare program abandons 1986 malpractice rule

Hospitals with claims "properly pending" before fiscal intermediaries or in the courts need do nothing in order to obtain corrected reimbursement for fiscal years so pending. However, to speed processing of corrected reimbursements for fiscal years pending in appeals before the PRRB, hospitals should request that the Board determine its jurisdiction and remand to the fiscal intermediary for payment as soon as possible. It will be helpful to include with any such request a copy of the notice of program reimbursement and the original appeal letter for each fiscal year under appeal. Despite the fact that HCFA Ruling 91-1 effectively concedes that HCFA has applied an invalid regulation to all fiscal years since May 1, 1986, HCFA counsel have stated that HCFA will not permit reopening of closed cost reports to correct the inappropriate apportionment of malpractice insurance costs. Nevertheless, hospitals that do not presently have a claim or appeal pending have several options. Under the Provider Reimbursement Manual, HIM-15, sections 2930-2931, fiscal intermediaries are required to reopen cost reports filed within the three-year reopening period to correct errors. Accordingly, should a fiscal intermediary deny a provider's reopening request, the provider should seriously consider taking an appeal to the PRRB. The PRRB's jurisdiction to review fiscal intermediary denials of requests to reopen cost reports was affirmed by the United States Court of Appeals for the Ninth Circuit, see State of Oregon v. Bowen, 854 F.2d 346 (9th Cir. 1988), a decision that is controlling in California, Oregon, Washington, Nevada, Arizona, Montana, Idaho, Hawaii, Alaska, Guam, and the Northern Mariana Islands.(ABSTRACT TRUNCATED AT 250 WORDS)