42 CFR 405.501 - Determination of reasonable charges

Cite as42 CFR 405.501
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26 practice notes
  • Alexander v. Schweicker, No. H-80-2.
    • United States
    • United States District Courts. 2nd Circuit. United States District Court (Connecticut)
    • March 23, 1981
    ...to Complaint of Intervenor Bernard 516 F. Supp. 184 V. Dunne as Exhibit II. 42 U.S.C. §§ 1395l (a), 1395l(b), 1395u(a), 1395u(b)(3); 42 C.F.R. §§ 405.501-405.501-405.511.3 Jurisdiction is alleged under 28 U.S.C. § 1331 (general federal question jurisdiction) and 28 U.S.C. § 1361 (mandamus j......
  • Walsh v. McGee, No. 89 Civ. 1310 (DNE).
    • United States
    • United States District Courts. 2nd Circuit. United States District Courts. 2nd Circuit. Southern District of New York
    • October 11, 1995
    ...it was "reasonable and necessary" under the circumstances, and whether its cost was "reasonable." 42 U.S.C. §§ 1395u(b)(3), 1395y(a); 42 C.F.R. §§ 405.501, 421.200. While the Act instructs carriers to consider specific criteria in making these determinations, a carrier may take into account......
  • Abbott Radiology Associates v. Shalala, No. 94-CV-390H.
    • United States
    • United States District Courts. 2nd Circuit. United States District Court of Western District of New York
    • November 20, 1997
    ...other providers of medical services.8 The Secretary maintains that any provider classified as a reasonable charge basis provider under 42 C.F.R. § 405.501 (1991) may be subject to comparability I find that the Secretary's interpretation of the phrase "on a charge basis" is a reasonable one ......
  • Furlong v. Shalala, Docket No. 97-6220
    • United States
    • U.S. Court of Appeals — Second Circuit
    • September 23, 1998
    ...had to be "reasonable," based on the prevailing charge for comparable services in the particular community. See id.; see generally 42 C.F.R. § 405.501 et seq. (1997). The Department subsequently promulgated a statutory fee schedule of Medicare-approved charges to replace this discretionary ......
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26 cases
  • Alexander v. Schweicker, No. H-80-2.
    • United States
    • United States District Courts. 2nd Circuit. United States District Court (Connecticut)
    • March 23, 1981
    ...to Complaint of Intervenor Bernard 516 F. Supp. 184 V. Dunne as Exhibit II. 42 U.S.C. §§ 1395l (a), 1395l(b), 1395u(a), 1395u(b)(3); 42 C.F.R. §§ 405.501-405.501-405.511.3 Jurisdiction is alleged under 28 U.S.C. § 1331 (general federal question jurisdiction) and 28 U.S.C. § 1361 (mandamus j......
  • Walsh v. McGee, No. 89 Civ. 1310 (DNE).
    • United States
    • United States District Courts. 2nd Circuit. United States District Courts. 2nd Circuit. Southern District of New York
    • October 11, 1995
    ...and necessary" under the circumstances, and whether its cost was "reasonable." 42 U.S.C. §§ 1395u(b)(3), 1395y(a); 42 C.F.R. §§ 405.501, 421.200. While the Act instructs carriers to consider specific criteria in making these determinations, a carrier may take into account add......
  • Abbott Radiology Associates v. Shalala, No. 94-CV-390H.
    • United States
    • United States District Courts. 2nd Circuit. United States District Court of Western District of New York
    • November 20, 1997
    ...other providers of medical services.8 The Secretary maintains that any provider classified as a reasonable charge basis provider under 42 C.F.R. § 405.501 (1991) may be subject to comparability I find that the Secretary's interpretation of the phrase "on a charge basis" is a reaso......
  • Furlong v. Shalala, Docket No. 97-6220
    • United States
    • U.S. Court of Appeals — Second Circuit
    • September 23, 1998
    ...be "reasonable," based on the prevailing charge for comparable services in the particular community. See id.; see generally 42 C.F.R. § 405.501 et seq. (1997). The Department subsequently promulgated a statutory fee schedule of Medicare-approved charges to replace this discretiona......
  • Request a trial to view additional results

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