42 CFR 413.9 - Cost related to patient care
| Cite as | 42 CFR 413.9 |
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110 practice notes
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Maximum Home Health Care, Inc. v. Shalala, No. 3:99-0299.
...of the Provider's (plaintiff) management fees was not supported by adequate documentation, as addressed in the regulations noted above, (42 CFR §§ 413.9, 413.20, and 413.24), the intermediary had to resort to other analyses. Competitive bids were not obtained for the management services. Do......
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Acadian Homecare L.L.C. v. Leavitt, Civil Action No. 06-577.
...care of beneficiaries. Reasonable costs includes all necessary and proper costs incurred in furnishing the services [to beneficiaries]. 42 C.F.R. 413.9(a). The regulations proceed to define "necessary and proper costs" as costs that are appropriate and helpful in maintaining the operation o......
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Battle Creek Health System v. Leavitt, No. 06-1775.
...reports of telephone and personal contact, etc."). These guidelines are in keeping with regulations that require documentation. See 42 C.F.R. §§ 413.9, 413.24, and 413.20(a) ("[t]he principles of cost reimbursement require that providers maintain sufficient financial records and statistical......
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Monongahela Valley Hosp., Inc. v. Sullivan, Nos. 90-3207
...services provided to Medicare beneficiaries on the basis of actual, reasonable costs incurred. 1 See 42 C.F.R. § 405.451, recodified at 42 C.F.R. § 413.9 (1990). 2 Primarily at issue are the regulations requiring health care providers that claim interest expense as a reimbursable cost of re......
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95 cases
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Maximum Home Health Care, Inc. v. Shalala, No. 3:99-0299.
...of the Provider's (plaintiff) management fees was not supported by adequate documentation, as addressed in the regulations noted above, (42 CFR §§ 413.9, 413.20, and 413.24), the intermediary had to resort to other analyses. Competitive bids were not obtained for the management services. Do......
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Acadian Homecare L.L.C. v. Leavitt, Civil Action No. 06-577.
...care of beneficiaries. Reasonable costs includes all necessary and proper costs incurred in furnishing the services [to beneficiaries]. 42 C.F.R. 413.9(a). The regulations proceed to define "necessary and proper costs" as costs that are appropriate and helpful in maintaining the operation o......
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Battle Creek Health System v. Leavitt, No. 06-1775.
...reports of telephone and personal contact, etc."). These guidelines are in keeping with regulations that require documentation. See 42 C.F.R. §§ 413.9, 413.24, and 413.20(a) ("[t]he principles of cost reimbursement require that providers maintain sufficient financial records and statistical......
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Monongahela Valley Hosp., Inc. v. Sullivan, Nos. 90-3207
...services provided to Medicare beneficiaries on the basis of actual, reasonable costs incurred. 1 See 42 C.F.R. § 405.451, recodified at 42 C.F.R. § 413.9 (1990). 2 Primarily at issue are the regulations requiring health care providers that claim interest expense as a reimbursable cost of re......
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2 firm's commentaries
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California Appellate Court Affirms Medi-Cal’s Obligation To Pay FQHCs 100% Of Their Reasonable Costs
...… The State cannot shirk its responsibility to pay health centers’ full costs.” Finally, the Court found that as a general rule, 42 C.F.R. Part 413 (Medicare reasonable cost principles) directs payment based on the actual costs of a provider rather than the costs of a contractor when an arm......
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Hospitals Face Sizable Overpayment Liability for Not Reporting Medical Device Credits
...42 C.F.R. §§ 412.89 and 419.45. [vi] 42 U.S.C. § 1395y(a)(2). [vii] 42 C.F.R. § 413.9. [viii] OIG, “Hospitals Did Not Comply With Medicare Requirements for Reporting Certain Cardiac Device Credits”, A-05-16-00059 (March [ix]...