42 C.F.R. §447.15 - Acceptance of State payment as payment in full

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105 cases
  • Banks v. Secretary of Indiana Family and Social Services Admin., 92-2299
    • United States
    • United States Courts of Appeals. United States Court of Appeals (7th Circuit)
    • June 15, 1993
    ...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......
  • Grier v. Goetz, 3:79-3107.
    • United States
    • United States District Courts. 6th Circuit. United States District Court of Middle District of Tennessee
    • November 15, 2005
    ...the co-payments charged for any TennCare service, it must do so within the confines of federal law. See, e.g., 42 U.S.C. § 1396o; 42 C.F.R. §§ 447.15, 447.53 (prohibiting co-payments for certain individuals and permitting only "nominal" Similarly, Plaintiffs concede that the 2003 Consent De......
  • Spectrum Health Cont. Care v. Anna Marie Bowling, 04-1486.
    • United States
    • United States Courts of Appeals. United States Court of Appeals (6th Circuit)
    • June 14, 2005
    ...full, the amounts 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. Consistent with this federal regulation, service providers in the Michigan Medicaid program must "accept payment from the state as payme......
  • Ansley v. Banner Health Network, 1 CA-CV 17-0075
    • United States
    • Court of Appeals of Arizona
    • March 12, 2019
    ...in situations covered by [ A.R.S. § 33-931 ]. A.R.S. § 36-2903.01(G)(4). ¶15 The Patients argue the Hospitals' liens are invalid under 42 C.F.R. § 447.15, a federal regulation issued in 1980. See 45 Fed. Reg. 24889 (Apr. 11, 1980). Federal regulations dictate the relationship between a stat......
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5 firm's commentaries
  • OIG Issues Supplemental Compliance Program Guidance For Nursing Facilities: Quality Of Care Is Top Risk Area
    • United States
    • Mondaq United States
    • October 17, 2008
    ...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
    • United States
    • JD Supra United States
    • March 23, 2020
    ...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
    • United States
    • JD Supra United States
    • April 4, 2018
    ...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
    • United States
    • LexBlog United States
    • March 19, 2019
    ...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,......
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