42 CFR Part 447
PART 447—PAYMENTS FOR SERVICES
- PART 447—PAYMENTS FOR SERVICES
- Chapter IV—Centers for Medicare & Medicaid Services, Department of Health and Human Services › Subchapter C—Medical Assistance Programs
- Subpart A—Payments: General Provisions
- § 447.1 Purpose.
- § 447.10 Prohibition against reassignment of provider claims.
- § 447.15 Acceptance of State payment as payment in full.
- § 447.20 Provider restrictions: State plan requirements.
- § 447.21 Reduction of payments to providers.
- § 447.25 Direct payments to certain beneficiaries for physicians' or dentists' services.
- § 447.26 Prohibition on payment for provider-preventable conditions.
- § 447.30 Withholding the Federal share of payments to Medicaid providers to recover Medicare overpayments.
- § 447.31 Withholding Medicare payments to recover Medicaid overpayments.
- § 447.40 Payments for reserving beds in institutions.
- § 447.45 Timely claims payment.
- § 447.46 Timely claims payment by MCOs.
- Medicaid Premiums and Cost Sharing
- § 447.50 Premiums and cost sharing: Basis and purpose.
- § 447.51 Definitions.
- § 447.52 Cost sharing.
- § 447.53 Cost sharing for drugs.
- § 447.54 Cost sharing for services furnished in a hospital emergency department.
- § 447.55 Premiums.
- § 447.56 Limitations on premiums and cost sharing.
- § 447.57 Beneficiary and public notice requirements.
- § 447.88 Options for claiming FFP payment for section 1920A presumptive eligibility medical assistance payments.
- § 447.90 FFP: Conditions related to pending investigations of credible allegations of fraud against the Medicaid program.
- Subpart B—Payment Methods: General Provisions
- § 447.200 Basis and purpose.
- § 447.201 State plan requirements.
- § 447.202 Audits.
- § 447.203 Documentation of access to care and service payment rates.
- § 447.204 Medicaid provider participation and public process to inform access to care.
- § 447.205 Public notice of changes in Statewide methods and standards for setting payment rates.
- Subpart C—Payment for Inpatient Hospital and Long-Term Care Facility Services
- § 447.250 Basis and purpose.
- Payment Rates
- § 447.251 Definitions.
- § 447.252 State plan requirements.
- § 447.253 Other requirements.
- § 447.255 Related information.
- § 447.256 Procedures for CMS action on assurances and State plan amendments.
- Federal Financial Participation
- § 447.257 FFP: Conditions relating to institutional reimbursement.
- Upper Limits
- § 447.271 Upper limits based on customary charges.
- § 447.272 Inpatient services: Application of upper payment limits.
- Swing-Bed Hospitals
- § 447.280 Hospital providers of NF services (swing-bed hospitals).
- Subpart D [Reserved]
- Subpart E—Payment Adjustments for Hospitals That Serve a Disproportionate Number of Low-Income Patients
- § 447.294 Medicaid disproportionate share hospital (DSH) allotment reductions.
- § 447.295 Hospital-specific disproportionate share hospital payment limit: Determination of individuals without health insurance or other third party coverage.
- § 447.296 Limitations on aggregate payments for disproportionate share hospitals for the period January 1, 1992 through September 30, 1992.
- § 447.297 Limitations on aggregate payments for disproportionate share hospitals beginning October 1, 1992.
- § 447.298 State disproportionate share hospital allotments.
- § 447.299 Reporting requirements.
- Subpart F—Payment Methods for Other Institutional and Noninstitutional Services
- § 447.300 Basis and purpose.
- § 447.302 State plan requirements.
- § 447.304 Adherence to upper limits; FFP.
- Outpatient Hospital and Clinic Services
- § 447.321 Outpatient hospital and clinic services: Application of upper payment limits.
- Other Inpatient and Outpatient Facilities
- § 447.325 Other inpatient and outpatient facility services: Upper limits of payment.
- § 447.342 [Reserved]
- Prepaid Capitation Plans
- § 447.362 Upper limits of payment: Nonrisk contract.
- Rural Health Clinic Services
- § 447.371 Services furnished by rural health clinics.
- Subpart G—Payments for Primary Care Services Furnished by Physicians
- § 447.400 Primary care services furnished by physicians with a specified specialty or subspecialty.
- § 447.405 Amount of required minimum payments.
- § 447.410 State plan requirements.
- § 447.415 Availability of Federal financial participation (FFP).
- Subpart H [Reserved]
- Subpart I—Payment for Drugs
- § 447.500 Basis and purpose.
- § 447.502 Definitions.
- § 447.504 Determination of average manufacturer price.
- § 447.505 Determination of best price.
- § 447.506 Authorized generic drugs.
- § 447.507 Identification of inhalation, infusion, instilled, implanted, or injectable drugs (5i drugs).
- § 447.508 Exclusion from best price of certain sales at a nominal price.
- § 447.509 Medicaid drug rebates (MDR).
- § 447.510 Requirement and penalties for manufacturers.
- § 447.511 Requirements for States.
- § 447.512 Drugs: Aggregate upper limits of payment.
- § 447.514 Upper limits for multiple source drugs.
- § 447.516 Upper limits for drugs furnished as part of services.
- § 447.518 State plan requirements, findings, and assurances.
- § 447.520 Federal Financial Participation (FFP): Conditions relating to physician-administered drugs.
- § 447.522 Optional coverage of investigational drugs and other drugs not subject to rebate.
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