1999 CFR Title 42, Volume 2

Title 42--Public Health CHAPTER IV--HEALTH CARE FINANCING ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 413--PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES
	413.1	Introduction.
	413.5	Cost reimbursement: General.
	413.9	Cost related to patient care.
	413.13	Amount of payment if customary charges for services furnished are less than reasonable costs.
	413.17	Cost to related organizations.
	413.20	Financial data and reports.
	413.24	Adequate cost data and cost finding.
	413.30	Limitations on payable costs.
	413.35	Limitations on coverage of costs: Charges to beneficiaries if cost limits are applied to services.
	413.40	Ceiling on the rate of increase in hospital inpatient costs.
	413.50	Apportionment of allowable costs.
	413.53	Determination of cost of services to beneficiaries.
	413.60	Payments to providers: General.
	413.64	Payments to providers: Specific rules.
	413.70	Payment for services of a CAH.
	413.74	Payment to a foreign hospital.
	413.80	Bad debts, charity, and courtesy allowances.
	413.85	Cost of educational activities.
	413.86	Direct graduate medical education payments.
	413.88	Incentive payments under plans for voluntary reduction in number of medical residents.
	413.90	Research costs.
	413.92	Costs of surety bonds.
	413.94	Value of services of nonpaid workers.
	413.98	Purchase discounts and allowances, and refunds of expenses.
	413.100	Special treatment of certain accrued costs.
	413.100	Special treatment of certain accrued costs.
	413.102	Compensation of owners.
	413.106	Reasonable cost of physical and other therapy services furnished under arrangements.
	413.114	Payment for posthospital SNF care furnished by a swing-bed hospital.
	413.118	Payment for facility services related to covered ASC surgical procedures performed in hospitals on an outpatient basis.
	413.122	Payment for hospital outpatient radiology services and other diagnostic procedures.
	413.123	Payment for screening mammography performed by hospitals on an outpatient basis.
	413.124	Reduction to hospital outpatient operating costs.
	413.125	Payment for home health agency services.
	413.130	Introduction to capital-related costs.
	413.134	Depreciation: Allowance for depreciation based on asset costs.
	413.139	Depreciation: Optional allowance for depreciation based on a percentage of operating costs.
	413.144	Depreciation: Allowance for depreciation on fully depreciated or partially depreciated assets.
	413.149	Depreciation: Allowance for depreciation on assets financed with Federal or public funds.
	413.153	Interest expense.
	413.157	Return on equity capital of proprietary providers.
	413.170	Scope.
	413.172	Principles of prospective payment.
	413.174	Prospective rates for hospital-based and independent ESRD facilities.
	413.176	Amount of payments.
	413.178	Bad debts.
	413.180	Procedures for requesting exceptions to payment rates.
	413.182	Criteria for approval of exception requests.
	413.184	Payment exception: Atypical service intensity (patient mix).
	413.186	Payment exception: Isolated essential facility.
	413.188	Payment exception: Extraordinary circumstances.
	413.190	Payment exception: Self-dialysis training costs.
	413.192	Payment exception: Frequency of dialysis.
	413.194	Appeals.
	413.196	Notification of changes in rate-setting methodologies and payment rates.
	413.198	Recordkeeping and cost reporting requirements for outpatient maintenance dialysis.
	413.200	Payment of independent organ procurement organizations and histocompatibility laboratories.
	413.202	Organ procurement organization (OPO) cost for kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
	413.203	Transplant center costs for organs sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
	413.300	Basis and scope.
	413.302	Definitions.
	413.304	Eligibility for prospectively determined payment rates.
	413.308	Rules governing election of prospectively determined payment rates.
	413.310	Basis of payment.
	413.312	Methodology for calculating rates.
	413.314	Determining payment amounts: Routine per diem rate.
	413.316	Determining payment amounts: Ancillary services.
	413.320	Publication of prospectively determined payment rates or amounts.
	413.321	Simplified cost report for SNFs.
	413.330	Basis and scope.
	413.333	Definitions.
	413.335	Basis of payment.
	413.337	Methodology for calculating the prospective payment rates.
	413.340	Transition period.
	413.343	Resident assessment data.
	413.345	Publication of Federal prospective payment rates.
	413.348	Limitation on review.
	413.350	Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A services.