[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: 42CFR415.164]



[Page 805]

 

                         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. 415.164  Payment to a fund.



    (a) General rules. Payment for certain voluntary services by 

physicians in teaching hospitals (as these services are described in 

Sec. 415.160) is made on a salary equivalent basis (as described in 

Sec. 415.162(d)) subject to the conditions and limitations contained in 

parts 405 and 413 of this chapter and this part 415, to a single fund 

(as defined in paragraph (b) of this section) designated by the 

organized medical staff of the hospital (or, if the services are 

furnished in the hospital by the faculty of a medical school, to a fund 

as may be designated by the faculty), if the following conditions are 

met:

    (1) The hospital (or medical school furnishing the services under 

arrangement with the hospital) incurs no actual cost in furnishing the 

services.

    (2) The hospital has an agreement with CMS under part 489 of this 

chapter.

    (3) The intermediary, or CMS as appropriate, has received written 

assurances that--

    (i) The payment is used solely for the improvement of care of 

hospital patients or for educational or charitable purposes; and

    (ii) Neither the individuals who are furnished the services nor any 

other persons are charged for the services (and if charged, provision is 

made for the return of any monies incorrectly collected).

    (b) Definition of a fund. For purposes of paragraph (a) of this 

section, a fund is an organization that meets either of the following 

requirements:

    (1) The organization has and retains exemption, as a governmental 

entity or under section 501(c)(3) of the Internal Revenue Code 

(nonprofit educational, charitable, and similar organizations), from 

Federal taxation.

    (2) The organization is an organization of physicians who, under the 

terms of their employment by an entity that meets the requirements of 

paragraph (b)(1) of this section, are required to turn over to that 

entity all income that the physician organization derives from the 

physician services.

    (c) Status of a fund. A fund approved for payment under paragraph 

(a) of this section has all the rights and responsibilities of a 

provider under Medicare except that it does not enter into an agreement 

with CMS under part 489 of this chapter.