[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

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

[CITE: 42CFR489.25]



[Page 948]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 489_PROVIDER AGREEMENTS AND SUPPLIER APPROVAL--Table of Contents

 

               Subpart B_Essentials of Provider Agreements

 

Sec. 489.25  Special requirements concerning CHAMPUS and CHAMPVA programs.



    For inpatient services, a hospital that participates in the Medicare 

program must participate in any health plan contracted under 10 U.S.C. 

1079 or 1086 (Civilian Health and Medical Program of the Uniformed 

Services) and under 38 U.S.C. 613 (Civilian Health and Medical Program 

of the Veterans Administration) and accept the CHAMPUS/CHAMPVA-

determined allowable amount as payment in full, less applicable 

deductible, patient cost-share, and noncovered items. Hospitals must 

meet the requirements of 32 CFR part 199 concerning program benefits 

under the Department of Defense. This section applies to inpatient 

services furnished to beneficiaries admitted on or after January 1, 

1987.



[59 FR 32123, June 22, 1994]