42 CFR 447.15 - Acceptance of State payment as payment in full
| Cite as | 42 CFR 447.15 |
-
- This document is available in original version only for vLex customers
View this document and try vLex for 7 days - TRY VLEX
- This document is available in original version only for vLex customers
110 practice notes
-
Securing Updated and Necessary Statutory Evaluations Timely
...of amount, duration, and scope of Medicaid services, found at 42 CFR 440.230-440.250. The Medicaid balanced billing regulation at 42 CFR 447.15. Regulations that shape children's access to care in a wide range of areas, including but not limited to: 42 CFR 438.1-438.930-- Medicaid Managed C......
-
Olszewski v. Scrippshealth, No. D034197.
..."must limit participation in the Medicaid program to providers who accept, as payment in full, the amounts paid by the agency. . . ." (42 C.F.R. § 447.15.) Therefore, under federal law, ScrippsHealth was eligible for Medi-Cal money only if it agreed to accept the Medi Cal money as payment i......
-
Olszewski v. Scripps Health, No. S098409.
...135 Cal.Rptr.2d 13 paid by the agency plus any deductible, coinsurance or copayment required by the plan to be paid by the individual" (42 C.F.R. § 447.15, italics added).8 Section 1396a(a)(25)(C) of title 42 United States Code Service then provides "that in the case of an individual who is......
-
Banks v. Secretary of Indiana Family and Social Services Admin., No. 92-2299
...prohibited from seeking payment from a Medicaid recipient of amounts not reimbursed by the state program. As the Secretary points out, 42 C.F.R. § 447.15 provides that "[a] state plan must provide that the Medicaid agency must limit participation in the Medicaid program to providers who acc......
Request a trial to view additional results
96 cases
-
Olszewski v. Scrippshealth, No. D034197.
..."must limit participation in the Medicaid program to providers who accept, as payment in full, the amounts paid by the agency. . . ." (42 C.F.R. § 447.15.) Therefore, under federal law, ScrippsHealth was eligible for Medi-Cal money only if it agreed to accept the Medi Cal money as payment i......
-
Olszewski v. Scripps Health, No. S098409.
...135 Cal.Rptr.2d 13 paid by the agency plus any deductible, coinsurance or copayment required by the plan to be paid by the individual" (42 C.F.R. § 447.15, italics added).8 Section 1396a(a)(25)(C) of title 42 United States Code Service then provides "that in the case of an individual who is......
-
Banks v. Secretary of Indiana Family and Social Services Admin., No. 92-2299
...prohibited from seeking payment from a Medicaid recipient of amounts not reimbursed by the state program. As the Secretary points out, 42 C.F.R. § 447.15 provides that "[a] state plan must provide that the Medicaid agency must limit participation in the Medicaid program to providers who acc......
-
Ill. Health Maintenance v. Dept. of Ins., No. 1-05-2422.
...The Association argues that the requisite legal prohibition is supplied by federal Medicaid law (42 U.S.C. § 1396a(a)(25)(C) (2000); 42 C.F.R. § 447.15 (2006)) which, according to the Association, bars the Providers in the case at bar from collecting any amount from AHCP enrollees who were ......
Request a trial to view additional results
5 firm's commentaries
-
OIG Issues Supplemental Compliance Program Guidance For Nursing Facilities: Quality Of Care Is Top Risk Area
...32 42 U.S.C. 1395nn. 33 Note 1, supra, at p. 56845. 34 Id.; see also 66 Fed. Reg. 856, 923 (January 4, 2001). 35 42 U.S.C. 1395cc(a); 42 CFR 447.15, 36 42 U.S.C. 1395w-101. 37 Note 1, supra, at p. 56846-47. 38 See CMS Survey and Certification Group's May 11, 2006 letter to State Survey Agen......
-
The Supreme Court of Arizona Holds That Hospitals May Not Use Liens Against Third-Party Tortfeasors to Balance Bill Medicaid Patients
...AHCCCS’ reimbursement. Plaintiffs filed the class action lawsuit against the hospitals alleging that 42 U.S.C. § 1396a(a)(25)(C) and 42 C.F.R. § 447.15 (federal Medicaid law and regulations), prohibited hospitals from balance billing patients, or in other words, collecting payments beyond r......
-
Hospitals Cannot Enforce Liens Against AHCCCS Patients’ Third-Party Recoveries
...from enforcing those liens on their tort recoveries. The trial court ruled in favor of the patients, holding that federal regulation – 42 C.F.R. § 447.15 – preempts the hospitals’ state-law statutory lien right. The court prohibited the hospitals from asserting any lien after having receive......
-
Plaintiffs Get to Keep Windfall Damages
...at *1. However, federal law governs the relationship between state Medicaid agencies and the hospitals they contract with. Pursuant to 42 C.F.R. § 447.15, “a state may contract only with providers that agree to ‘accept, as payment in full, the amounts paid by the agency plus any deductible,......
Request a trial to view additional results