Medicare program; payment for physician services furnished in institutional providers of services--HCFA. Proposed rule.
These proposed rules would, in part, implement section 1887 of the Social Security Act, which was established by section 108 of the Tax Equity and Fiscal Responsibility Act of 1982. We are proposing to revise the regulations that govern Medicare coverage and reimbursement for services of physicians who practice in institutional providers (hospitals and skilled nursing facilities). The proposed regulations would set forth basic criteria for reasonable charge payment for those services, and would clarify how reasonable charges would be determined for physician services furnished by physicians in a provider setting. The regulations also would specify the conditions under which Medicare will pay on a reasonable cost basis for physician services to providers, and would provide improved tests of reasonableness for Medicare carriers and intermediaries to follow in determining payment. In addition, the proposed regulations would establish more specific conditions for payment for the services of anesthesiologists, radiologists, and pathologists.
D014487:Centers for Medicare and Medicaid Services, U.S.; D007357:Insurance, Physician Services / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence*; D014481:United States