Medicare program; application of inherent reasonableness to all Medicare Part B services (other than physician services)--HCFA. Interim final rule with comment period.
This interim final rule implements section 4316 of the Balanced Budget Act of 1997. It revises the process for establishing a realistic and equitable payment amount for all Medicare Part B services (other than physician services) when the existing payment amounts are inherently unreasonable because they are either grossly excessive or deficient. This rule describes the factors HCFA (or its carrier) will consider and the procedures it will follow in establishing realistic and equitable payment amounts.
D000368:Aged; D014487:Centers for Medicare and Medicaid Services, U.S.; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence; D016345:Medicare Part B / Q000331:legislation & jurisprudence*; D011907:Rate Setting and Review / Q000331:legislation & jurisprudence*; D014481:United States