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Social Security Act §1862
- https://www.ssa.gov/OP_Home/ssact/title18/1862.htm
- The Commissioner of Social Security shall, not less often that annually, transmit to the Secretary of the Treasury a list of the names and TINs of Medicare beneficiaries (as defined in section 6103(l)(12) of the Internal Revenue Code of 1986) and request that the …
Social Security Act §1861
- https://www.ssa.gov/OP_Home/ssact/title18/1861.htm
- The term “durable medical equipment” includes iron lungs, oxygen tents, hospital beds, and wheelchairs (which may include a power-operated vehicle that may be …
Social Security Act §1834
- https://www.ssa.gov/OP_Home/ssact/title18/1834.htm
- Any supplier of medical equipment and supplies who knowingly and willfully distributes a certificate of medical necessity in violation of clause (i) or fails to …
Social Security Act §1814
- https://www.ssa.gov/OP_Home/ssact/title18/1814.htm
- In the case of a specified area or medical topic determined appropriate by the Secretary for which a feasible and practical measure has not been endorsed by the entity with a …
The Social Security Act | CMS - Centers for Medicare
- https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DME_SSAct
- The Social Security Act Title XVIII of the Social Security Act is administered by the Centers for Medicare and Medicaid Services. The following sections are from Title …
Social Security Act Title XVIII - Social Security …
- https://www.ssa.gov/OP_Home/ssact/title18/1800.htm
- Sec. 1860D-16. Medicare prescription drug account in the federal supplementary medical insurance trust fund. Subpart 3—Application to Medicare Advantage Program and …
The Essentials of Medical Necessity
- https://www.dolbey.com/the-essentials-of-medical-necessity/
- The Social Security Act defines medical necessity as follows: “Notwithstanding any other provisions of this title, no payment may be made under Part A or Part B …
Q&A: Defining medical necessity | ACDIS
- https://acdis.org/articles/qa-defining-medical-necessity
- Medical necessity will always be a subjective term that may never have clear parameters as to what is or is not considered “necessary.” In other words, …
Medical Necessity and the Law - FindLaw
- https://www.findlaw.com/healthcare/patient-rights/medical-necessity-and-the-law.html
- The Affordable Care Act doesn't detail what constitutes medical necessity directly, but rather the Act mandates the similar "essential health packages," which …
Inpatient Admission and Medical Review Criteria
- https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/022714-2-Midnight-Rule-presentation.pdf
- Social Security Act §1814(a) requires physician certification of the medical necessity of services to be provided on an inpatient basis Order to admit is a critical element for …
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