[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR415.152]



[Page 798-799]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 415_SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING 

PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS

--Table of Contents

 

            Subpart D_Physician Services in Teaching Settings

 

Sec. 415.152  Definitions.



    As used in this subpart--

    Approved graduate medical education (GME) program means one of the 

following:

    (1) A residency program approved by the Accreditation Council for 

Graduate Medical Education of the American Medical Association, by the 

Committee on Hospitals of the Bureau of Professional Education of the 

American Osteopathic Association, by the Commission on Dental 

Accreditation of the American Dental Association, or by the Council on 

Podiatric Medicine Education of the American Podiatric Medical 

Association.

    (2) A program otherwise recognized as an ``approved medical 

residency program'' under Sec. 413.75(b) of this chapter.

    Direct medical and surgical services means services to individual 

beneficiaries that are either personally furnished by a physician or 

furnished by a resident under the supervision of a physician in a 

teaching hospital making the cost election described in Sec. Sec. 

415.160 through 415.162.

    Nonprovider setting means a setting other than a hospital, skilled 

nursing



[[Page 799]]



facility, home health agency, or comprehensive outpatient rehabilitation 

facility in which residents furnish services. These include, but are not 

limited to, family practice or multispecialty clinics and physician 

offices.

    Resident means one of the following:

    (1) An individual who participates in an approved GME program, 

including programs in osteopathy, dentistry, and podiatry.

    (2) A physician who is not in an approved GME program, but who is 

authorized to practice only in a hospital, for example, individuals with 

temporary or restricted licenses, or unlicensed graduates of foreign 

medical schools. For purposes of this subpart, the term resident is 

synonymous with the terms intern and fellow.

    Teaching hospital means a hospital engaged in an approved GME 

residency program in medicine, osteopathy, dentistry, or podiatry.

    Teaching physician means a physician (other than another resident) 

who involves residents in the care of his or her patients.

    Teaching setting means any provider, hospital-based provider, or 

nonprovider settings in which Medicare payment for the services of 

residents is made under the direct GME payment provisions of Sec. Sec. 

413.75 through 413.83, or on a reasonable-cost basis under the 

provisions of Sec. 409.26 or Sec. 409.40(f) for resident services 

furnished in skilled nursing facilities or home health agencies, 

respectively.



[60 FR 63178, Dec. 8, 1995, as amended at 61 FR 59554, Nov. 22, 1996; 63 

FR 26359, May 12, 1998; 70 FR 47490, Aug. 12, 2005]