PART 412--PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES
Subpart D--Basic Methodology for Determining Prospective Payment Federal Rates for Inpatient Operating Costs
412.64 Federal rates for inpatient operating costs for Federal fiscal year 2005 and subsequent fiscal years.
PART 413--PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END–STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES
Subpart E--Payments to Providers
413.70 Payment for services of a CAH.
PART 422--MEDICARE ADVANTAGE PROGRAM
Subpart G--Payments to Medicare Advantage Organizations
422.304 Monthly payments.
422.306 Annual MA capitation rates.
422.308 Adjustments to capitation rates, benchmarks, bids, and payments.
422.322 Source of payment and effect of MA plan election on payment.
SUBCHAPTER G--STANDARDS AND CERTIFICATIONS
PART 495--STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM
Subpart A--General Provisions
495.2 Basis and purpose.
495.4 Definitions.
495.6 Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.
495.8 Demonstration of meaningful use criteria.
495.10 Participation requirements for EPs, eligible hospitals, and CAHs.
Subpart B--Requirements Specific to the Medicare Program
495.100 Definitions.
495.102 Incentive payments to EPs.
495.104 Incentive payments to eligible hospitals.
495.106 Incentive payments to CAHs.
495.108 Posting of required information
495.110 Preclusion on administrative and judicial review.
Subpart C--Requirements Specific to Medicare Advantage (MA) Organizations
495.200 Definitions.
495.202 Identification of qualifying MA organizations, MA-EPs and MA-affiliated eligible hospitals.
495.204 Incentive payments to qualifying MA organizations for MA-EPs and MAaffiliated eligible hospitals.
495.206 Timeframe for payment to qualifying MA organizations.
495.208 Avoiding duplicate payment.
495.210 Meaningful EHR user attestation.
495.212 Limitation on review.
Subpart D--Requirements Specific to the Medicaid Program
495.300 Basis and purpose.
495.302 Definitions.
495.304 Medicaid provider scope and eligibility.
495.306 Establishing patient volume.
495.308 Net average allowable costs as the basis for determining the incentive payment.
495.310 Medicaid provider incentive payments.
495.312 Process for payments.
495.314 Activities required to receive an incentive payment.
495.316 State monitoring and reporting regarding activities required to receive an incentive payment.
495.318 State responsibilities for receiving FFP.
495.320 FFP for payments to Medicaid providers.
495.322 FFP for reasonable administrative expenses.
495.324 Prior approval conditions.
495.326 Disallowance of FFP.
495.328 Request for reconsideration of adverse determination.
495.330 Termination of FFP for failure to provide access to information.
495.332 State Medicaid health information technology (HIT) plan requirements.
495.334 [Reserved]
495.336 Health information technology planning advance planning document requirements (HIT PAPD).
495.338 Health information technology implementation advance planning document requirements (HIT IAPD).
495.340 As-needed HIT PAPD update and as-needed HIT IAPD update requirements.
495.342 Annual HIT IAPD requirements.
495.344 Approval of the State Medicaid HIT plan, the HIT PAPD and update, the HIT IAPD and update, and the annual HIT IAPD.
495.346 Access to systems and records.
495.348 Procurement standards.
495.350 State Medicaid agency attestations.
495.352 Reporting requirements.
495.354 Rules for charging equipment.
495.356 Nondiscrimination requirements.
495.358 Cost allocation plans.
495.360 Software and ownership rights.
495.362 Retroactive approval of FFP with an effective date of February 18, 2009.
495.364 Review and assessment of administrative activities and expenses of Medicaid provider health information technology adoption and operation.
495.366 Financial oversight and monitoring of expenditures.
495.368 Combating fraud and abuse
495.370 Appeals process for a Medicaid provider receiving electronic health record incentive payments.
Authority: Catalog of Federal Domestic Assistance Program No. 93.773, Medicare--Hospital Insurance; and Program No. 93.774, Medicare--Supplementary Medical Insurance Program, Program No. 93.778, Medical Assistance Program.
Dated: June 16, 2010.
Approved: July 9, 2010
Kathleen Sebelius,
Secretary.
[FR Doc. 2010-17207 Filed 07/13/2010 at 8:45 am; Publication Date: 07/28/2010]