Title 42, Part 489 — Provider Agreements and Supplier Approval
49 sections
Section 489.1
Statutory basis.
Section 489.2
Scope of part.
Section 489.3
Definitions.
Section 489.10
Basic requirements.
Section 489.11
Acceptance of a provider as a participant.
Section 489.12
Decision to deny an agreement.
Section 489.13
Effective date of agreement or approval.
Section 489.18
Change of ownership or leasing: Effect on provider agreement.
Section 489.20
Basic commitments.
Section 489.21
Specific limitations on charges.
Section 489.22
Special provisions applicable to prepayment requirements.
Section 489.23
Specific limitation on charges for services provided to certain enrollees of fee-for-service FEHB plans.
Section 489.24
Special responsibilities of Medicare hospitals in emergency cases.
Section 489.25
Special requirements concerning CHAMPUS and CHAMPVA programs.
Section 489.26
Special requirements concerning veterans.
Section 489.27
Beneficiary notice of discharge or change in status rights.
Section 489.28
Special capitalization requirements for HHAs.
Section 489.29
Special requirements concerning beneficiaries served by the Indian Health Service, Tribal health programs, and urban Indian organization health programs.
Section 489.30
Allowable charges: Deductibles and coinsurance.
Section 489.31
Allowable charges: Blood.
Section 489.32
Allowable charges: Noncovered and partially covered services.
Section 489.34
Allowable charges: Hospitals participating in State reimbursement control systems or demonstration projects.
Section 489.35
Notice to intermediary.
Section 489.40
Definition of incorrect collection.
Section 489.41
Timing and methods of handling.
Section 489.42
Payment of offset amounts to beneficiary or other person.
Section 489.52
Termination by the provider.
Section 489.53
Termination by CMS.
Section 489.54
Termination by the OIG.
Section 489.55
Exceptions to effective date of termination.
Section 489.57
Reinstatement after termination.
Section 489.60
Definitions.
Section 489.61
Basic requirement for surety bonds.
Section 489.62
Requirement waived for Government-operated HHAs.
Section 489.63
Parties to the bond.
Section 489.64
Authorized Surety and exclusion of surety companies.
Section 489.65
Amount of the bond.
Section 489.66
Additional requirements of the surety bond.
Section 489.67
Term and type of bond.
Section 489.68
Effect of failure to obtain, maintain, and timely file a surety bond.
Section 489.69
Evidence of compliance.
Section 489.70
Effect of payment by the Surety.
Section 489.71
Surety's standing to appeal Medicare determinations.
Section 489.72
Effect of review reversing determination.
Section 489.73
Effect of conditions of payment.
Section 489.74
Incorporation into existing provider agreements.
Section 489.100
Definition.
Section 489.102
Requirements for providers.
Section 489.104
Effective dates.