Health Care Financing Administration definition

Health Care Financing Administration means the Health Care Financing
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Health Care Financing Administration. 2000: n. pag. Data Sets for Research. 5 Feb. 2002.
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Health Care Financing Administration. [`HHS'] to carry out the provisions of the Social Security Act by administering Part B of the Medicare program (a copy of the contract is attached as Exhibit A). Medicare Part B provides supplemental benefits for aged and disabled individuals who elect to enroll under such program and is financed by premium payments from enrollees, together with funds appropriated by the federal government, 42 U.S.C. 1395j. The Secretary of HHS is authorized to enter into contracts with entities to carry out the provisions of the Act, 42 U.S.C. 1395u. The Act sets out requirements for the contract and, pursuant to the contract, [the Company] assumes many of the responsibilities of the government in administering the Medicare Program. "[The Company] determines the coverage of services; the reasonable charges for the services furnished; and makes the payments determined to be due for those services rendered to eligible individuals. (Article II, p.2, Contract). The contract details the procedure [the Company] must utilize in determining reasonable charges and coverage of services. (Article V, p.5, Contract). It also provides a hearing procedure that must be followed when requests for payment are denied, not acted upon with reasonable promptness, or when the amount or such payments is in controversy. (Article XI, p.10, Contract).
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Examples of Health Care Financing Administration in a sentence

  • This includes when the de- partment is notified by the Health Care Financing Administration, Department of Health and Human Services, that a practitioner has been suspended from participation under the Medicare program.

  • I authorize any holder of medical information about me to release to the Health Care Financing Administration and its agents any information needed to determine these benefits or the benefits payable for related services.

  • The federal law requiring that clinical laboratories be approved by the U.S. Department of Health and Human Services, Health Care Financing Administration.

  • AmSurg and Seller acknowledge that the rule proposed in June 1998 by the Health Care Financing Administration ("HCFA") providing in part for a change in the payment methodology and payment rates utilized by HCFA to reimburse ambulatory surgery centers as it may be adopted or amended (the "Proposed Rule"), could have a negative effect on the future revenues and earnings of the Center.

  • I authorize any holder of medical information about me to release to the Centers for Medicare and Medicaid Services (formerly Health Care Financing Administration) and its agents any information needed to determine these benefits or the benefits payable for related services.

  • These practitioners shall be suspended from participation in the medical assistance program effective on the date established by the Health Care Financing Administration and at least for the period of time of the Medicare suspension.d. Suspension or withholding of payments to provider.e. Referral to peer review.f. Prior authorization of services.g. One hundred percent review of the provider’s claim prior to payment.h. Referral to the state licensing board for investigation.

  • All services provided pursuant to this contract shall be provided in accordance with all applicable federal and state laws including The Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, sections 261-264 (the Administrative Simplification sections) and the regulations promulgated pursuant thereto and regulations of the Joint Commission on Accreditation of Healthcare Organization and the Health Care Financing Administration.

  • Under Section 2176 of the Omnibus Budget Reconciliation Act of 1981, states were allowed to request a waiver from the Health Care Financing Administration (HCFA) so that they could use Medicaid (Title XIX) funds for home and community based services.

  • This is the most recent average malpractice insurance rate information available and was deter- mined by the Health Care Financing Administration using nationwide surveys from hospitals report- ing malpractice data.

  • Further, the Parties hereto agree to comply with and to be bound by, to the same extent as if the sections were restated in their entirety herein, the provisions of 42 CFR §417.479 and 42 CFR §434.70, as amended by the final rule effective January 1, 1997, and as promulgated by the CMS (formerly the Health Care Financing Administration, DHHS).

Related to Health Care Financing Administration

  • Health care institution means any facility as defined in

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Health care provider or "provider" means:

  • Home Health Care Agency means an agency or organization which provides a program of home health care and which:

  • Indian Health Care Provider means a health care program operated by the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian Organization (otherwise known as an I/T/U) as those terms are defined in § 4 of the Indian Health Care Improvement Act (25 USC § 1603). Indian Health Care Provider includes a 638 Facility and provision of Indian Health Service Contract Health Services (IHS CHS).

  • Federal Health Care Program means any “federal health care program” as defined in 42 U.S.C. § 1320a-7b(f), including Medicare, state Medicaid programs, state CHIP programs, the Veterans Administration, TRICARE and similar or successor programs with or for the benefit of any Governmental Authority, and in each case any third party payor administering such programs.

  • Health care insurer means a disability insurer, group

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Health care services means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.

  • Home health care services means medical and nonmedical services, provided to ill, disabled or infirm persons in their residences. Such services may include homemaker services, assistance with activities of daily living and respite care services.

  • Health care facility or "facility" means hospices licensed

  • Family child care provider means a person who: (a) Provides

  • Home Health Care means the continual care and treatment of an individual if:

  • Managed health care system means: (a) Any health care

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Emergency medical care provider means an individual who has been trained to provide emergency and nonemergency medical care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic, paramedic specialist or other certification levels recognized by the department before 1984 and who has been issued a certificate by the department.

  • Health care organization ’ means any person or en-

  • State purchased health care or "health care" means medical

  • Medicare Provider Agreement means an agreement entered into between CMS or other such entity administering the Medicare program on behalf of CMS, and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Health care facilities means buildings, structures, or equipment suitable and intended for, or incidental or ancillary to, use in providing health services, including, but not limited to, hospitals; hospital long-term care units; infirmaries; sanatoria; nursing homes; medical care facilities; outpatient clinics; ambulatory care facilities; surgical and diagnostic facilities; hospices; clinical laboratories; shared service facilities; laundries; meeting rooms; classrooms and other educational facilities; students', nurses', interns', or physicians' residences; administration buildings; facilities for use as or by health maintenance organizations; facilities for ambulance operations, advanced mobile emergency care services, and limited advanced mobile emergency care services; research facilities; facilities for the care of dependent children; maintenance, storage, and utility facilities; parking lots and structures; garages; office facilities not less than 80% of the net leasable space of which is intended for lease to or other use by direct providers of health care; facilities for the temporary lodging of outpatients or families of patients; residential facilities for use by the aged or disabled; and all necessary, useful, or related equipment, furnishings, and appurtenances and all lands necessary or convenient as sites for the health care facilities described in this subdivision.

  • Health-care-insurance receivable means an interest in or claim under a policy of insurance which is a right to payment of a monetary obligation for health-care goods or services provided.

  • Health care means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.

  • Health care entity means any health care provider, health plan or health care clearinghouse.

  • Postsecondary educational institution means a degree- or certificate-granting public or private college or university, junior college, or community college that is located in this state. The term includes the governing body of the postsecondary educational institution.