Cms Hospital Provider Agreement

Provider Agreement: an agreement between CMS and one of the providers referred to in section 489.2(b) to provide services to Medicare beneficiaries and to meet the requirements of Section 1866 of the Act. 1. A supplier may charge the beneficiary an amount that does not exceed the difference between (a) the basic rule. An HHA entering medicare on or after January 1, 1998, including a new HHA as a result of a change in ownership, must, if the change in ownership leads to the issuance of a new provider number, have, at the time of application submission and at any time during the enrollment process, until the end of the three-month period following the transfer, of the resources we call “initial means of reserve exploitation”. For hospital services, a medicare hospital must participate in any health plan completed at 10 U.S.C 1079 or 1086 (Civilian Health and Medical Program of the Uniformesd Services) and 38 U.S.C. 613 (Civilian Health and Medical Program of the Veterans Administration) and accept the authorized amount set by CHAMPUS/CHAMPVA as full payment, less the applicable deductible, patient`s participation in expenses and uncovered items. Hospitals must meet the requirements of 32 CFR Part 199 with respect to program delivery under the Department of Defense. This Section shall apply to stationary services for beneficiaries which were admitted on or after 1 January 1987. .

. . .