42 CFR 413.53 - Determination of cost of services to beneficiaries

Cite as42 CFR 413.53
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21 practice notes
  • State of Fla., Office of Atty. v. Tenet Healthcare, 05-20591-CIV.
    • United States
    • United States District Courts. 11th Circuit. United States District Courts. 11th Circuit. Southern District of Florida
    • August 29, 2005
    ...be reasonably and consistently related to its costs of providing the services. Id. (citing Prov. Reimb. Man., Part 1, §§ 2202-2203; 42 C.F.R. § 413.53(b)(2)(ii)). As CMS indicated in September 1988, "the use of hospital-specific cost-to-charge ratios is essential to ensure that outlier paym......
  • Visiting Nurse Ass'n of Brooklyn v. Thompson, 99CV7564 NGG/CLP.
    • United States
    • United States District Courts. 2nd Circuit. United States District Court (Eastern District of New York)
    • December 7, 2004
    ...Manual ("PRM") § 3205. This provision, which was issued as an interpretation of the cost-reporting regulations contained in 42 C.F.R. § 413.53, instructs home health aide services providers to include only "Medicare-type" services in reporting the costs of services rendered to non-Medicare ......
  • Good Samaritan Hospital v. Shalala, 91-2079
    • United States
    • United States Supreme Court
    • June 7, 1993
    ...services is apportioned on the basis of the ratio of Medicare beneficiary charges to total patient charges in each department. See 42 CFR § 413.53(a)(1) (1992). The combined reimbursement for all of the different services performed by a health care provider, as calculated under all of the d......
  • UNIVERSITY HOSP., NY UNIV. MED. CTR. v. Bowen, 87 Civ. 1080 (WCC).
    • United States
    • United States District Courts. 2nd Circuit. United States District Courts. 2nd Circuit. Southern District of New York
    • May 2, 1988
    ...specifically charged to particular patients. See 42 C.F.R. §§ 405.452(b)(1), 405.452(d)(2), 405.452(d)(5) (1982) (current version at 42 C.F.R. 413.53(a)(1), 413.53(b) 684 F. Supp. 1237 (1987)). Routine costs are themselves subdivided into routine costs for general patient care areas, and ro......
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15 cases
  • Good Samaritan Hospital v. Shalala, No. 91-2079
    • United States
    • United States Supreme Court
    • June 7, 1993
    ...services is apportioned on the basis of the ratio of Medicare beneficiary charges to total patient charges in each department. See 42 CFR § 413.53(a)(1) (1992). The combined reimbursement for all of the different services performed by a health care provider, as calculated under all of the d......
  • State of Fla., Office of Atty. v. Tenet Healthcare, No. 05-20591-CIV.
    • United States
    • United States District Courts. 11th Circuit. United States District Courts. 11th Circuit. Southern District of Florida
    • August 29, 2005
    ...be reasonably and consistently related to its costs of providing the services. Id. (citing Prov. Reimb. Man., Part 1, §§ 2202-2203; 42 C.F.R. § 413.53(b)(2)(ii)). As CMS indicated in September 1988, "the use of hospital-specific cost-to-charge ratios is essential to ensure that outlier paym......
  • Visiting Nurse Ass'n of Brooklyn v. Thompson, No. 99CV7564 NGG/CLP.
    • United States
    • United States District Courts. 2nd Circuit. United States District Court (Eastern District of New York)
    • December 7, 2004
    ...Manual ("PRM") § 3205. This provision, which was issued as an interpretation of the cost-reporting regulations contained in 42 C.F.R. § 413.53, instructs home health aide services providers to include only "Medicare-type" services in reporting the costs of services rendered to non-Medicare ......
  • UNIVERSITY HOSP., NY UNIV. MED. CTR. v. Bowen, No. 87 Civ. 1080 (WCC).
    • United States
    • United States District Courts. 2nd Circuit. United States District Courts. 2nd Circuit. Southern District of New York
    • May 2, 1988
    ...specifically charged to particular patients. See 42 C.F.R. §§ 405.452(b)(1), 405.452(d)(2), 405.452(d)(5) (1982) (current version at 42 C.F.R. 413.53(a)(1), 413.53(b) 684 F. Supp. 1237 (1987)). Routine costs are themselves subdivided into routine costs for general patient care areas, and ro......
  • Request a trial to view additional results

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