42 C.F.R. §421.100 - Intermediary functions

Cite as42 C.F.R. §421.100
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63 practice notes
  • Gentiva Health Servs., Inc. v. Cochran, Civil Action No. 19-2271 (RDM)
    • United States
    • United States District Courts. United States District Court (Columbia)
    • 3 Marzo 2021
    ...on Medicare Administrative Contractors ("MACs") to administer the process for the payment of providers, including hospice caregivers. 42 C.F.R. §§ 421.100 – 421.104 ; 42 U.S.C. § 1395h(a). To do so, MACs must cope with the following difficulty: Although the Medicare statute requires MACs to......
  • Stringfellow Mem'l Hosp. v. Azar, Civil Action No. 17–309 (BAH)
    • United States
    • United States District Courts. United States District Court (Columbia)
    • 29 Junio 2018
    ...to be made to providers for covered services furnished to Medicare beneficiaries" and then "[m]aking the payments" to the hospitals. 42 C.F.R. § 421.100(a)(1)–(2) ; see also id. § 421.3. If a hospital providing covered services "is dissatisfied with a final determination of the organization......
  • Hays Med. Ctr. v. Azar, 17-3232
    • United States
    • United States Courts of Appeals. United States Court of Appeals (10th Circuit)
    • 21 Abril 2020
    ...are private entities that, acting as the Secretary’s agent, process Medicare claims. See 42 U.S.C. § 1395h ; 42 C.F.R. §§ 421.3, 421.100. As relevant here, reimbursement of participating hospitals’ Medicare Part A costs is sought and made through these intermediaries, and as part of that pr......
  • State of N.Y. v. Lutheran Center for the Aging, Inc., CV 96-4056 (ADS).
    • United States
    • United States District Courts. 2nd Circuit. United States District Court (Eastern District of New York)
    • 21 Febrero 1997
    ...processing claims to determine whether they are covered by Medicare and if so, the amount of Medicare payment. 42 U.S.C. § 1395h; 42 C.F.R. §§ 421.100(a), 421.103, 421.200(a). The conditions under which payment is granted or denied are not relevant to the Court's A fiscal intermediary's det......
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