Medicare program; payments to HMOs and CMPs and appeals: technical amendments--HCFA. Final rule with comment period.
This rule clarifies and updates portions of the HCFA regulations that pertain to payment for services furnished to Medicare enrollees by health maintenance organizations (HMOs) and competitive medical plans (CMPs); appeals by Medicare enrollees concerning payment for those services; and appeals by HMOs and CMPs with regard to their Medicare contracts. This rule completes the special project aimed at the total technical revision of part 417. Part 417 contains the regulations applicable to all prepaid health care organizations, that is, HMOs, CMPs, and health care prepayment plans (HCPPs). These are technical and editorial changes that do not affect the substance of the regulations. They are intended to make it easier to find particular provisions, to eliminate needless repetition and remove obsolete content, and to better ensure uniform understanding of the rules.
D014487:Centers for Medicare and Medicaid Services, U.S.; D016536:Competitive Medical Plans / Q000191:economics*; D006279:Health Maintenance Organizations / Q000191:economics*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000191:economics / Q000331:legislation & jurisprudence*; D014481:United States