42 CFR 421.404 - Assignment of providers and suppliers to MACs

Cite as42 CFR 421.404
    • This document is available in original version only for vLex customers

      View this document and try vLex for 7 days
    • TRY VLEX
8 practice notes
  • Goffney v. Becerra, No. 19-56368
    • United States
    • United States Courts of Appeals. United States Court of Appeals (9th Circuit)
    • 29. April 2021
    ...§§ 1395u(a), 1395kk-1(a) ; 42 C.F.R. § 421.5(b). Each Medicare contractor is responsible for a particular region of the country. 42 C.F.R. § 421.404(b)(1), (c)(1).To be paid for performing Medicare services, healthcare providers must enroll in the program, at which point they receive billin......
  • Almy v. Sebelius, Civil Action No. RDB–08–1245.
    • United States
    • United States District Courts. 1st Circuit. United States District Courts. 1st Circuit. District of Massachusetts
    • 3. September 2010
    ...by the Centers for Medicare and Medicaid Services (“CMS”) has its own DMAC. 42 U.S.C. § 1395m(a)(12); 42 C.F.R. §§ 424.32, 421.210(b), 421.404(c)(2). If the DMAC determines that the DME item is covered or otherwise reimbursable under Medicare, it will furnish a payment amount that is equal ......
  • Gordian Med., Inc. v. Sebelius, No. CV 10-3933 CAS (FFMx)
    • United States
    • United States District Courts. 9th Circuit. United States District Courts. 9th Circuit. Central District of California
    • 4. April 2012
    ...("DME MACs") (formerly known as DME Regional Carriers or "DMERCs"). Id. §§ 1395m(a)(12), 1395kk-1; 42 C.F.R. §§ 421.200, 421.210(b), 421.404(c)(2). 4. Medical supplies and other items of DMEPOS must be furnished "incident to a physician's service" or by a "supplier" that possesses both a va......
  • Odell v. U.S. Dep't of Health & Human Servs., No. 19-15262
    • United States
    • United States Courts of Appeals. United States Court of Appeals (9th Circuit)
    • 27. April 2021
    ...See 42 U.S.C. §§ 1395u(a), 1395kk-1(a) ; 42 C.F.R. § 421.5(c). Each contractor is responsible for a particular region of the country. 42 C.F.R. § 421.404(b)(1), (c)(1).Medicare pays only for services that are "reasonable and necessary." 42 U.S.C. § 1395y(a)(1)(A). The Medicare contractor de......
  • Request a trial to view additional results
6 cases
  • Almy v. Sebelius, Civil Action No. RDB–08–1245.
    • United States
    • United States District Courts. 1st Circuit. United States District Courts. 1st Circuit. District of Massachusetts
    • 3. September 2010
    ...by the Centers for Medicare and Medicaid Services (“CMS”) has its own DMAC. 42 U.S.C. § 1395m(a)(12); 42 C.F.R. §§ 424.32, 421.210(b), 421.404(c)(2). If the DMAC determines that the DME item is covered or otherwise reimbursable under Medicare, it will furnish a payment amount that is equal ......
  • Goffney v. Becerra, No. 19-56368
    • United States
    • United States Courts of Appeals. United States Court of Appeals (9th Circuit)
    • 29. April 2021
    ...§§ 1395u(a), 1395kk-1(a) ; 42 C.F.R. § 421.5(b). Each Medicare contractor is responsible for a particular region of the country. 42 C.F.R. § 421.404(b)(1), (c)(1).To be paid for performing Medicare services, healthcare providers must enroll in the program, at which point they receive billin......
  • Gordian Med., Inc. v. Sebelius, No. CV 10-3933 CAS (FFMx)
    • United States
    • United States District Courts. 9th Circuit. United States District Courts. 9th Circuit. Central District of California
    • 4. April 2012
    ...("DME MACs") (formerly known as DME Regional Carriers or "DMERCs"). Id. §§ 1395m(a)(12), 1395kk-1; 42 C.F.R. §§ 421.200, 421.210(b), 421.404(c)(2). 4. Medical supplies and other items of DMEPOS must be furnished "incident to a physician's service" or by a "supplier" that possesses both a va......
  • Odell v. U.S. Dep't of Health & Human Servs., No. 19-15262
    • United States
    • United States Courts of Appeals. United States Court of Appeals (9th Circuit)
    • 27. April 2021
    ...See 42 U.S.C. §§ 1395u(a), 1395kk-1(a) ; 42 C.F.R. § 421.5(c). Each contractor is responsible for a particular region of the country. 42 C.F.R. § 421.404(b)(1), (c)(1).Medicare pays only for services that are "reasonable and necessary." 42 U.S.C. § 1395y(a)(1)(A). The Medicare contractor de......
  • Request a trial to view additional results

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT