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42 U.S.C. § 1395j

Section 1395j - Establishment of supplementary medical insurance program for aged and disabled
Section 1395j - Establishment of supplementary medical insurance program for aged and disabled

6 Citing briefs

  1. United States of America v. United Health Group, Inc. et al

    NOTICE OF MOTION AND MOTION to Dismiss United States First Amended Complaint-In-Partial-Intervention; Memorandum of Points and Authorities in Support Thereof

    Filed December 8, 2017

    19 Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S. Ct. 1989 (2016) ................................................................................ passim STATUTES AND REGULATIONS 31 U.S.C.§ 3729(a)(1)(G) .................................................................................... 2, 11 31 U.S.C. § 3731(b) ................................................................................................. 20 42 U.S.C. § 1395c et seq. .......................................................................................... 3 42 U.S.C. § 1395j et seq. ........................................................................................... 3 42 U.S.C. § 1395w-21 et seq. .................................................................................... 4 42 U.S.C. § 1395w-23 ............................................................................................... 4 42 U.S.C. § 1395w-23(a)(1)(B) ................................................................................. 4 42 U.S.C. § 1395w-24(a)(6)(A)................................................................................. 4 Pub. L. No. 111-21, 123 Stat. 1617 (2009) ....................................................... 19, 20 42 C.F.R. § 422.254(b)(1) ......................................................................................... 4 74 Fed. Reg. 54,634 (Oct. 22, 2009) ......................................................................... 7 OTHER AUTHORITIES CMS, Notice of Final Payment Error Calculation Methodology (Feb. 24, 201

  2. Porzecanski v. Burwell

    Cross MOTION for Summary Judgment and Opposition to Plaintiff's Motion for Summary Judgment

    Filed June 27, 2017

    Medicare Part A generally covers inpatient hospital services and other institutional care (e.g., skilled nursing facility services), while Part B, implicated here, covers other medical items and services, including physicians’ services, hospital outpatient services, and diagnostic testing performed by clinical laboratories. See 42 U.S.C. § 1395c; 42 U.S.C. § 1395j; 42 U.S.C. § 1395k(a)(1). “Notwithstanding any other provision of [the Medicare statute], no payment may be made under part A or part B . . . for any expenses incurred or items or services, which . . . are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.”

  3. 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

    Part B benefits are supplemental health insurance benefits that cover certain physician, diagnostic, and other outpatient services for beneficiaries who voluntarily enroll and pay additional premiums. 42 U.S.C. §§ 1395j to 1395w-4; 42 C.F.R. Parts 407, 410. The Centers for Medicare & Medicaid Services (“CMS”) is the component of the Department of Health and Human Services (“HHS”) responsible for the administration of the Medicare program in conjunction with private entities known as Medicare Administrative Contractors (“MACs”) with which the Case 6:16-cv-00868-CEM-DCI Document 32 Filed 05/12/17 Page 2 of 20 PageID 642 3 Secretary enters into contracts pursuant to 42 U.S.C. §1395kk-1(a).2 See also 42 U.S.C. §1395u(a); Schweiker v. McClure, 456 U.S. 188, 190-91 (1982).

  4. Mccambridge v. Burwell

    MOTION for Summary Judgment

    Filed July 8, 2016

    Only Part B, which was established in Section 1831 of the Medicare statute, is relevant here. See 42 U.S.C. § 1395j. The Medicare statute and regulations create a program of “defined and limited benefits” that are tethered to “specific practitioner qualification requirements that aim to ensure that program beneficiaries receive high quality health care.”

  5. Anghel v. Sebelius

    MEMORANDUM OF DECISION AND ORDER - It is hereby: ORDERED, that the Plaintiffs motion for judgment on the pleadings is DENIED, except that the Court agrees that the overpayment at issue must be reduced

    Filed December 13, 2012

    Part B of the Medicare Program (“Part B”) authorizes payment for various medical and other health services and supplies, including outpatient services. See 42 U.S.C. § 1395j, et. seq.

  6. Lassiter et al v. Pacificare Life and Health Insurance Company et al

    BRIEF/MEMORANDUM in Support of Motion to Remand

    Filed July 17, 2007

    Before the recent extension of Medicare to cover a portion of prescription drug costs, Medicare covered only inpatient care through Part A and outpatient care through Part B. Parts A and B are fee-for-service insurance programs operated by the federal government. 42 U.S.C. § 1395c et seq. (Part A); 42 U.S.C. § 1395j et seq. (Part B). In 1997 Congress enacted Medicare Part C to allow Medicare beneficiaries to opt out of traditional fee-for-service coverage under Parts A and B. 42 U.S.C. § 1395w-21 et seq. (Part C).