[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: 42CFR489.1]



[Page 942]

 

                         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 A_General Provisions

 

Sec.  489.1  Statutory basis.





    This part implements section 1866 of the Social Security Act. 

Section 1866 specifies the terms of provider agreements, the grounds for 

terminating a provider agreement, the circumstances under which payment 

for new admissions may be denied, and the circumstances under which 

payment may be withheld for failure to make timely utilization review. 

The following other sections of that Act are also pertinent.

    (a) Section 1861 defines the services covered under Medicare and the 

providers that may be reimbursed for furnishing those services.

    (b) Section 1864 provides for the use of State survey agencies to 

ascertain whether certain entities meet the conditions of participation.

    (c) Section 1871 authorizes the Secretary to prescribe regulations 

for the administration of the Medicare program.

    (d) Although section 1866 of the Act speaks only to providers and 

provider agreements, the effective date rules in this part are made 

applicable also to the approval of suppliers that meet the requirements 

specified in Sec.  489.13.

    (e) Section 1861(o)(7) of the Act requires each HHA to provide CMS 

with a surety bond.



[45 FR 22937, Apr. 4, 1980, as amended at 51 FR 24492, July 3, 1986; 62 

FR 43936, Aug. 18, 1997; 63 FR 312, Jan. 5, 1998]