42 CFR 413.89 - Bad debts, charity, and courtesy allowances

Cite as42 CFR 413.89
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69 practice notes
  • Part III
    • United States
    • Federal Register November 18, 2008
    • November 18, 2008
    ...The bad debt policy is outside the scope of the proposed rule and this final rule with comment period. We refer the commenter to 42 CFR 413.89 and the Provider Reimbursement Manual Part I Chapter 3, concerning our bad debt requirements. Comment: One commenter noted that CMS did not respond ......
  • Cmty. Health Sys., Inc. v. Burwell, Civil Action No. 14–1432 (BAH)
    • United States
    • U.S. District Court — District of Columbia
    • July 7, 2015
    ...fail to pay this portion of their care, Medicare allows for reimbursement of these "bad debts" so long as certain criteria are met. 42 C.F.R. § 413.89(e). The principle underlying the reimbursement of Medicare bad debt is straightforward: "This policy, adopted in 1966[,] ... was originally ......
  • Cove Associates Joint Venture v. Sebelius, No. 1:10-cv-01316 (BJR)
    • United States
    • United States District Courts. United States District Court (Columbia)
    • March 26, 2012
    ...cost basis, including the unpaid deductible and coinsurance obligations of Medicare beneficiaries - or "bad debts" - at issue here. 42 C.F.R. § 413.89(a), (h). The Secretary has issued regulations regarding the financial documentation that providersPage 6must maintain for reimbursement purp......
  • Battle Creek Health System v. Leavitt, No. 06-1775.
    • United States
    • United States Courts of Appeals. United States Court of Appeals (6th Circuit)
    • August 14, 2007
    ...under the Medicare program because these bad debts are deemed "deductions from revenue and are not to be included in allowable cost." 42 C.F.R. § 413.89(a).2 The Secretary will nonetheless reimburse a provider for certain bad debts attributable to deductible and coinsurance amounts related ......
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44 cases
  • Cmty. Health Sys., Inc. v. Burwell, Civil Action No. 14–1432 (BAH)
    • United States
    • U.S. District Court — District of Columbia
    • July 7, 2015
    ...fail to pay this portion of their care, Medicare allows for reimbursement of these "bad debts" so long as certain criteria are met. 42 C.F.R. § 413.89(e). The principle underlying the reimbursement of Medicare bad debt is straightforward: "This policy, adopted in 1966[,] ... was originally ......
  • Cove Associates Joint Venture v. Sebelius, No. 1:10-cv-01316 (BJR)
    • United States
    • United States District Courts. United States District Court (Columbia)
    • March 26, 2012
    ...cost basis, including the unpaid deductible and coinsurance obligations of Medicare beneficiaries - or "bad debts" - at issue here. 42 C.F.R. § 413.89(a), (h). The Secretary has issued regulations regarding the financial documentation that providersPage 6must maintain for reimbursement purp......
  • Battle Creek Health System v. Leavitt, No. 06-1775.
    • United States
    • United States Courts of Appeals. United States Court of Appeals (6th Circuit)
    • August 14, 2007
    ...under the Medicare program because these bad debts are deemed "deductions from revenue and are not to be included in allowable cost." 42 C.F.R. § 413.89(a).2 The Secretary will nonetheless reimburse a provider for certain bad debts attributable to deductible and coinsurance amounts related ......
  • Abington Crest Nursing and Rehab. v. Leavitt, Civil No. 06-1932 (RJL).
    • United States
    • United States District Courts. United States District Court (Columbia)
    • March 28, 2008
    ...Order consistent with this ruling accompanies this Opinion. --------------- Notes: 1. This regulation was subsequently recodified at 42 C.F.R. § 413.89, see Medicare Program — Changes to Inpatient Prospective Payment Systems, 69 Fed.Reg. 48,916, 49,254 (Aug. 11, 2004), and was revised effec......
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13 firm's commentaries
  • First to File: Issue 2 (The week of Sept. 5-9, 2022)
    • United States
    • LexBlog United States
    • September 16, 2022
    ...Id. at 848. [15] Id. [16] Id. at 847 (emphasis added). [17] Id. at 851 (emphasis in the original). [18] Id. at 851. [19] Id. [20] 42 C.F.R. § 413.89(b), (e). [21] 42 C.F.R. § 413.89(e). [22] 31 U.S.C. § 3729(a)(1)(G). [23] 31 U.S.C. § 3730(h). [24] href="#_ftnref13" name="_ftn13">[13] Id. a......
  • D.C. District Court Issues Two Decisions Addressing CMS's Medicare Bad Debt "Must Bill" Policy – One Rejecting the Policy and the Other Upholding the Policy
    • United States
    • JD Supra United States
    • October 21, 2019
    ...unpaid copayments and deductibles for Medicare beneficiaries who are also eligible for Medicaid, i.e., dual eligible beneficiaries. See 42 C.F.R. § 413.89. For bad debt to be allowable, a provider must demonstrate, among other things, that no other source, including the state, is responsibl......
  • CMS's "At a Collection Agency" Bad Debt Policy - Confusion Continues
    • United States
    • JD Supra United States
    • August 26, 2015
    ...v. Burwell, C.A. No. 14-1432 (D.D.C. 2015) [PDF]. The court concluded that the agency's interpretation of the bad debt regulation, 42 C.F.R. § 413.89(e), and the "at a collection agency" position are both reasonable. The court ruled that, under the regulation, a debt is not "worthless" with......
  • CMS Issues IPPS/LTCH Proposed Rule for FY 2021
    • United States
    • JD Supra United States
    • May 19, 2020
    ...Debt Policy CMS proposes to clarify, update, and codify what CMS indicates are “longstanding Medicare bad debt principles” by revising 42 C.F.R. § 413.89. [23] The commentary contains substantial discussion and proposed revisions to regulations, including related to reasonable collection ef......
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