CMS Rulings are decisions of the Administrator that serve as precedent final opinions and orders and statements of policy and interpretation. They provide clarification and interpretation of complex or ambiguous provisions of the law or regulations relating to Medicare, Medicaid, Utilization and Quality Control Peer Review, private health insurance, and related matters.
| CMS-1536-R | This Ruling sets forth the policy of the CMS concerning the requirements for determining payment made for insertion of astigmatism-conecting intraocular lenses following cataract surgery under the following sections of the Act. |
| CMS Ruling 01-01 | The National and Local Coverage Determination Review Process for an Individual with Standing as Defined in Section 522 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protections Act of 2000. |
| HCFA Ruling 97-1 | Requirements for determining limitation on liability of a medicare beneficiary, provider, practitioner, or other supplier for partial hospitalization services for which Medicare payment is denied. |
| CMS Ruling 05-01 | Requirements for Determining Coverage of Presbyopia-Correcting Intraocular Lenses that Provide Two Distinct Services for the Patient: (1) Restoration of Distance Vision Following Cataract Surgery, and (2) Refractive Correction of Near and Intermediate Vision with Less Dependency on Eyeglasses or Contact Lenses |
| HCFA Ruling 96-1 | Medicare Supplementary Medical Insurance (Part B)
CLARIFICATION OF THE TERMS "ORTHOTICS," "BRACES," AND "DURABLE MEDICAL EQUIPMENT" UNDER MEDICARE PART B |
| HCFA Ruling 98-1 | Medicare Supplementary Medical Insurance (Part B)
THE ADMINISTRATIVE APPEALS PROCESS FOR PHYSICIANS, NON-PHYSICIAN PRACTITIONERS, AND ENTITIES THAT RECEIVE REASSIGNED BENEFITS AND THAT ARE NOT PROVIDED APPEAL RIGHTS UNDER 42 CFR PART 498 |
| HCFA Ruling 97-2 | Hospital Insurance (Part A). INTERPRETATION OF MEDICAID DAYS INCLUDED IN THE MEDICARE DISPROPORTIONATE SHARE ADJUSTMENT CALCULATION |
| HCFA Ruling 96-2 | Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) REQUIREMENTS FOR DETERMINING LIMITATION ON LIABILITY OF A MEDICARE BENEFICIARY, SUPPLIER, PRACTITIONER, OR OTHER SUPPLIER FOR PAP SMEARS AND MAMMOGRAPHY SERVICES FOR WHICH MEDICARE PAYMENT IS DENIED. |
| HCFA Ruling 96-3 | Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) REQUIREMENTS FOR DETERMINING LIMITATION ON LIABILITY OF A MEDICARE BENEFICIARY, PROVIDER, PRACTITIONER, OR OTHER SUPPLIER FOR PARENTERAL AND ENTERAL NUTRITION THERAPY, INCLUDING INTRADIALYTIC PARENTERAL NUTRITION THERAPY, SERVICES AND ITEMS FOR WHICH MEDICARE PAYMENT IS DENIED. |
| HCFA Ruling 95-1 | Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) REQUIREMENTS FOR DETERMINING LIMITATION ON LIABILITY OF A MEDICARE BENEFICIARY, PROVIDER, PRACTITIONER, OR OTHER SUPPLIER FOR CERTAIN SERVICES AND ITEMS FOR WHICH MEDICARE PAYMENT IS DENIED. |
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