Health Care Financing Administration: prohibition of reassignment of claims by providers and suppliers. Final rule.
These regulations prohibit a provider or a physician or other supplier of services from reassigning claims for Medicare reimbursement, except in certain specified situations. They also impose administrative sanctions on providers or physicians or other suppliers who violate the prohibition. A provider who violates this prohibition is subject to termination of its provider agreement; a physician or other supplier is subject to revocation of the right to receive assignment from Medicare beneficiaries. The regulations also impose the same administrative sanction on physicians and other suppliers who violate their assignment agreements, chiefly their agreement to accept the reasonable charge as the full charge for the service. The regulations implement certain provisions of the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977 (Pub. L. 95-142). They are designed to prevent the sale of Medicare claims at a discount from face value and to protect beneficiaries from becoming liable for excessive charges by physicians and other suppliers.
D006300:Health Services Misuse; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence*; D014481:United States