[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: 42CFR418.402]



[Page 932-933]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 418_HOSPICE CARE--Table of Contents

 

                          Subpart H_Coinsurance

 

Sec. 418.402  Individual liability for services that are not considered 

hospice care.



    Medicare payment to the hospice discharges an individual's liability 

for payment for all services, other than the hospice coinsurance amounts 

described in Sec. 418.400, that are considered covered hospice care (as 

described in Sec. 418.202). The individual is liable for the Medicare 

deductibles and coinsurance payments and for the difference between the 

reasonable and actual charge on unassigned claims on other covered 

services that are not considered hospice care. Examples of services



[[Page 933]]



not considered hospice care include: Services furnished before or after 

a hospice election period; services of the individual's attending 

physician, if the attending physician is not an employee of or working 

under an arrangement with the hospice; or Medicare services received for 

the treatment of an illness or injury not related to the individual's 

terminal condition.