42 C.F.R. §484.205 - Basis of payment
| Cite as | 42 C.F.R. §484.205 |
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13 cases
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Healey v. Thompson, 3:98CV418(DJS).
...requirements, and a number of other related changes." Id. at 41128. The linchpin of the HH PPS is the sixty-day episode of care. See 42 C.F.R. § 484.205(a). When a patient eligible for Medicare coverage requires home health care services, the physician, in conjunction with the provider, dev......
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United States ex rel. Prather v. Brookdale Senior Living Cmtys., Inc., 17-5826
...The initial payment—the "request for anticipated payment" or "RAP"—is a percentage of the total expected reimbursement. Id. (citing 42 C.F.R. § 484.205(b) ). The second payment—the "residual final payment"—is disbursed at the end of the episode. Id. (citing 42 C.F.R. § 484.205(b) ).892 F.3d......
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United States ex rel. Prather v. Brookdale Senior Living Cmtys., Inc., 15–6377
...a percentage of the anticipated episode payment, and a “residual final payment” that is paid after the end of the 60-day episode. See 42 C.F.R. § 484.205(b) ; R. 79-1 (2011 Medicare Claims Processing Manual § 10.1.12) (Page ID #1085). Payment, therefore, is not based on a fee-for-service mo......
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United States v. Univ. of TN Med. Ctr. Home Care Servs., 3:17-CV-96
...that the patients are homebound, and that the patients require one of the types of home health services that qualifies for Medicare. 42 C.F.R. § 484.205(a). After receiving a patient referral, a home health agency is required to provide its own patient-specific, comprehensive assessment, ca......
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