[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR488.3]



[Page 658]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 488_SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES--Table of 

 

                      Subpart A_General Provisions

 

Sec.  488.3  Conditions of participation; conditions for coverage; and 



long-term care requirements.



    (a) Basic rules. In order to be approved for participation in or 

coverage under the Medicare program, a prospective provider or supplier 

must:

    (1) Meet the applicable statutory definition in section 1138(b), 

1819, 1832(a)(2)(F), 1861, 1881, or 1919 of the Act; and

    (2) Be in compliance with the applicable conditions or long-term 

care requirements prescribed in subpart N, Q or U of part 405, part 416, 

subpart C of part 418, part 482, part 483, part 484, part 485, subpart A 

of part 491, or part 494 of this chapter.

    (b) Special Conditions. (1) The Secretary, after consultation with 

the JCAHO or AOA, may issue conditions of participation for hospitals 

higher or more precise than those of either those accrediting bodies.

    (2) The Secretary may, at a State's request, approve health and 

safety requirements for providers and suppliers in that State, which are 

higher than those otherwise applied in the Medicare program.

    (3) If a State or political subdivision imposes higher requirements 

on institutions as a condition for the purchase of health services under 

a State Medicaid Plan approved under Title XIX of the Act, (or if Guam, 

Puerto Rico, or the Virgin Islands does so under a State plan for Old 

Age Assistance under Title I of the Act, or for Aid to the Aged, Blind, 

and Disabled under the original Title XVI of the Act), the Secretary is 

required to impose similar requirements as a condition for payment under 

Medicare in that State or political subdivision.



[53 FR 22859, June 17, 1988, as amended at 58 FR 61838, Nov. 23, 1993]



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