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42 U.S.C. § 1395h

Section 1395h - Provisions relating to the administration of part A
Section 1395h - Provisions relating to the administration of part A

14 Citing briefs

  1. Baystate Medical Center v. Leavitt, et al

    MOTION for Summary Judgment

    Filed April 11, 2007

    CMS, in turn, uses contractors known as “fiscal intermediaries” to process hospital claims. 42 U.S.C. § 1395h. 3.

  2. Shands Jacksonville Medical Center, Inc. et al v. Sebelius

    MOTION for Summary Judgment and Opposition to Plaintiffs' Motions for Summary Judgment

    Filed June 30, 2017

    Hospitals then submit cost reports at the end of each Fiscal Year (“FY”) to Medicare contractors, generally private insurance companies acting on behalf of the Secretary. See 42 U.S.C. § 1395h(a); 42 C.F.R. §§ 405.1801(b)(1), 413.

  3. Dch Regional Medical Center v. Burwell

    MOTION to Dismiss for Lack of Jurisdiction

    Filed December 6, 2016

    To obtain payment, hospitals and other Part A providers submit cost reports at the end of each fiscal year to contractors acting on behalf of HHS. See 42 U.S.C. §§ 1395h, 1395kk-1. The contractors were formerly known as fiscal intermediaries, but are now known as Medicare Administrative Contractors (MACs).

  4. Mercy General Hospital et al v. Burwell

    Cross MOTION for Summary Judgment and Opposition to Plaintiffs' Motion for Summary Judgment

    Filed October 11, 2016

    These entities are now known as “Medicare administrative contractors” or “MACs.” See 42 U.S.C. § 1395h. The MAC determines the payment to be made to the provider based on audits of the provider’s annual cost reports.

  5. Beacon Respiratory Services, Inc. v. Secretary, United States Department of Health And Human Services

    MOTION for judgment on the pleadings , or In The Alternative, Cross Motion for Summary Judgment and Memorandum in Support

    Filed May 12, 2017

    C. Initial Determinations and the Appeal Process Many aspects of the Medicare program are administered by CMS through private contractors. See 42 U.S.C. §§ 1395h, 1395u. Cigna Government Services (“CGS”) was the DME MAC for Jurisdiction C at all relevant times.7 CMS contractors, called Zone Program Integrity Contractors (“ZPICs”), may audit Medicare claims on behalf of the MAC and CMS.

  6. University of Colorado Health at Memorial Hospital et al v. Burwell

    MOTION for Partial Summary Judgment

    Filed February 9, 2017

    In 2005, fiscal intermediaries were replaced by Medicare administrative contractors over a transition period. See 42 U.S.C. § 1395h; 42 C.F.R. §413.24(f).

  7. Pinnacle Peak Neurology Llc v. Noridian Healthcare Solutions Llc

    MOTION to Dismiss Case Defendant Noridan Healthcare Solutions, LLC's Motion to Dismiss

    Filed December 7, 2016

    ¶¶ 5, 8, 9, 15, 19). See also 42 U.S.C. § 1395h; 42 C.F.R. §§ 421.100, 421.

  8. Loma Linda University Kidney Center v. Burwell

    Cross MOTION for Summary Judgment

    Filed October 21, 2016

    Congress has authorized the Secretary to contract with private contractors, typically insurance companies, including those known today as Medicare administrative contractors (“MACs”), and who were known during previous periods as Medicare “fiscal intermediaries,” to assist the Secretary in processing claims for Medicare payment. 42 U.S.C. §§ 1395h(a), 1395u, 1395kk- 1(a)(4); 42 C.F.R. § 421.100.

  9. Fairbanks Memorial Hospital v. Burwell

    Cross MOTION for Summary Judgment

    Filed September 26, 2016

    She has delegated considerable authority for administration of the Medicare program to the Administrator of the Centers for Medicare & Medicaid Services (“CMS”) (formerly the Health Care Financing Administration). Congress has authorized the Secretary to contract with private contractors, typically insurance companies, including those known today as Medicare administrative contractors (“MACs”), and who were known during previous periods as Medicare “fiscal intermediaries,” to assist the Secretary in processing hospitals’ claims for payment under Medicare Part A. 42 U.S.C. §§ 1395h(a), 1395kk-1(a)(4); 42 C.F.R. § 421.100.

  10. Trostle et al v. Centers For Medicare And Medicaid Services

    REPLY BRIEF re MOTION to Dismiss Defendant, USA's, Reply to Plaintiff's Respnse to Defendant's Memorandum of Law in Support of Its Motion to Dismiss

    Filed August 5, 2016

    CMS is authorized to use contractors to administer the Medicare program. See 42 U.S.C. §§ 1395h, 1395u; 42 C.F.R. § 421.5.