[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR489.60]



[Page 963-964]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 489_PROVIDER AGREEMENTS AND SUPPLIER APPROVAL--Table of Contents

 

               Subpart F_Surety Bond Requirements for HHAs

 

Sec.  489.60  Definitions.



    Source: 63 FR 313, Jan. 5, 1998, unless otherwise noted.





    As used in this subpart unless the context indicates otherwise--

    Assessment means a sum certain that CMS may assess against an HHA in 

lieu of damages under Titles XI, XVIII, or XXI of the Social Security 

Act or under regulations in this chapter.

    Assets includes but is not limited to any listing that identifies 

Medicare beneficiaries to whom home health services were furnished by a 

participating or formerly participating HHA.

    Civil money penalty means a sum certain that CMS has the authority 

to impose on an HHA as a penalty under Titles XI, XVIII, or XXI of the 

Social Security Act or under regulations in this chapter.

    Participating home health agency means a ``home health agency'' 

(HHA), as that term is defined by section 1861(o) of the Social Security 

Act, that



[[Page 964]]



also meets the definition of a ``provider'' set forth at Sec.  400.202 

of this chapter.

    Rider means a notice issued by a Surety that a change in the bond 

has occurred or will occur.

    Surety bond means one or more bonds issued by one or more surety 

companies under 31 U.S.C. 9304 to 9308 and 31 CFR parts 223, 224, and 

225, provided the bond otherwise meets the requirements of this section.

    Unpaid civil money penalty or assessment means a civil money penalty 

or assessment imposed by CMS on an HHA under Titles XI, XVIII, or XXI of 

the Social Security Act, plus accrued interest, that, after the HHA or 

Surety has exhausted all administrative appeals, remains unpaid (because 

the civil money penalty or assessment has not been paid to, or offset or 

compromised by, CMS) and is not the subject of a written arrangement, 

acceptable to CMS, for payment by the HHA. In the event a written 

arrangement for payment, acceptable to CMS, is made, an unpaid civil 

money penalty or assessment also means such civil money penalty or 

assessment, plus accrued interest, that remains due 60 days after the 

HHA's default on such arrangement.

    Unpaid claim means a Medicare overpayment for which the HHA is 

responsible, plus accrued interest, that, 90 days after the date of the 

agency's notice to the HHA of the overpayment, remains due (because the 

overpayment has not been paid to, or recouped or compromised by, CMS) 

and is not the subject of a written arrangement, acceptable to CMS, for 

payment by the HHA. In the event a written arrangement for payment, 

acceptable to CMS, is made, an unpaid claim also means a Medicare 

overpayment for which the HHA is responsible, plus accrued interest, 

that remains due 60 days after the HHA's default on such arrangement.



[63 FR 313, Jan. 5, 1998, as amended at 63 FR 29655, June 1, 1998]