42 CFR 413.302 - Definitions. | Title 42 - Public Health | Code of Federal Regulations

§ 413.302

Definitions.

For purposes of this subpart—

Area wage level means the average wage per hour for all classifications of employees as reported by health care facilities within a specified area.

Census region means one of the 9 census divisions, comprising the 50 States and the District of Columbia, established by the Bureau of the Census for statistical and reporting purposes.

Routine capital-related costs means the capital-related costs, allowable for Medicare purposes (as described in subpart G of this part), that are allocated to the SNF participating inpatient routine service cost center as reported on the Medicare cost report.

Routine operating costs means the cost of regular room, dietary, and nursing services, and minor medical and surgical supplies for which a separate charge is not customarily made. It does not include the costs of ancillary services, capital-related costs, or, where appropriate, return on equity.

Rural area means any area outside an urban area in a census region.

Urban area means—

(1) Prior to October 1, 2004, a Metropolitan Statistical Area (MSA), or New England County Metropolitan Area (NECMA), as defined by the Office of Management and Budget, or a New England county deemed to be an urban area as listed in § 412.62(f)(1)(ii)(B) of this chapter.

(2) Effective October 1, 2004, a Metropolitan Statistical Area (MSA), as defined by the Office of Management and Budget, or a New England county deemed to be an urban area as specified under § 412.64.

[60 FR 37594, July 21, 1995, as amended at 69 FR 49265, Aug. 11, 2004]

Title 42 published on 2012-10-01

The following are only the Rules published in the Federal Register after the published date of Title 42.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

2013-03-13; vol. 78 # 49 - Wednesday, March 13, 2013

78 FR 15882 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2013-05724
RIN	0938-AR12
	CMS-1588-CN4

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule; correction.

Effective date: This correcting document is effective March 12, 2013. Applicability Date: This correcting document is applicable to discharges on or after October 1, 2012.

42 CFR Parts 412, 413, 424, and 476

Summary

This document corrects technical errors in the correcting document that appeared in the October 3, 2012 Federal Register entitled “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Correction.”

2012-11-09; vol. 77 # 218 - Friday, November 9, 2012

77 FR 67450 - Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Bad Debt Reductions for All Medicare Providers

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-26903
RIN	0938-AR13
	CMS-1352-F

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule.

Effective Date: These regulations are effective on January 1, 2013. Applicability Date: The regulations setting forth the reductions in Medicare bad debt pursuant to section 3201 of the Middle Class Tax Extension and Job Creation Act of 2012 (Pub. L. 112-96) are applicable for cost reporting periods beginning October 1, 2012.

42 CFR Parts 413 and 417

Summary

This final rule updates and makes revisions to the end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2013. This rule also sets forth requirements for the ESRD quality incentive program (QIP), including for payment year (PY) 2015 and beyond. In addition, this rule implements changes to bad debt reimbursement for all Medicare providers, suppliers, and other entities eligible to receive Medicare payment for bad debt and removes the cap on bad debt reimbursement to ESRD facilities. (See the Table of Contents for a listing of the specific issues addressed in this final rule.)

2012-10-29; vol. 77 # 209 - Monday, October 29, 2012

77 FR 65495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-26505
RIN	0938-AR12
	CMS-1588-CN3

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule; correction.

Effective Date: October 26, 2012.

42 CFR Parts 412, 413, 424, and 476

Summary

This document corrects technical errors that appeared in the final rule that appeared in the August 31, 2012 Federal Register entitled “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers.”

2012-10-23; vol. 77 # 205 - Tuesday, October 23, 2012

77 FR 64755 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 2; Corrections

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-25975
RIN	-0938-AQ84
	CMS-0044-CN2

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule; correction.

Effective Date: This document is effective on November 12, 2012, except that the correction to instruction 8.NN (77 FR 54149) is effective October 23, 2012.

42 CFR Parts 412, 413, and 495

Summary

This document corrects technical errors and typographical errors in the final rule entitled “Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 2” which appeared in the September 4, 2012 issue of the Federal Register .

2012-10-03; vol. 77 # 192 - Wednesday, October 3, 2012

77 FR 60315 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-24307
RIN	0938-AR12
	CMS-1588-CN2

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule; correction.

Effective Date: October 1, 2012.

42 CFR Parts 412, 413, 424, and 476

Summary

This document corrects technical errors in the final rule that appeared in the August 31, 2012 Federal Register entitled “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers.”

This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.

United States Code

U.S.C. : Title 42 - THE PUBLIC HEALTH AND WELFARE

§ 1302 - Rules and regulations; impact analyses of Medicare and Medicaid rules and regulations on small rural hospitals

§ 1395 - Prohibition against any Federal interference

§ 1395d - Scope of benefits

§ 1395f - Conditions of and limitations on payment for services

§ 1395g - Payments to providers of services

42 USC § -

§ 1395x - Definitions

§ 1395hh - Regulations

§ 1395rr - End stage renal disease program

§ 1395tt - Hospital providers of extended care services

§ 1395ww - Payments to hospitals for inpatient hospital services

Statutes at Large

113 Stat. 1501A-332

Public Laws

106-133

Title 42 published on 2012-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR 413 after this date.

2013-05-06; vol. 78 # 87 - Monday, May 6, 2013

78 FR 26438 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2014

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2013-10558
RIN	0938-AR65
	CMS-1446-P

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Proposed rule.

To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on July 1, 2013.

42 CFR Parts 413 and 424

Summary

This proposed rule would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2014, would revise and rebase the SNF market basket, and would make certain technical and conforming revisions in the regulations text. This proposed rule also includes a proposed policy for reporting the SNF market basket forecast error correction in certain limited circumstances and a proposed new item for the Minimum Data Set (MDS), Version 3.0.

2013-03-13; vol. 78 # 49 - Wednesday, March 13, 2013

78 FR 15882 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2013-05724
RIN	0938-AR12
	CMS-1588-CN4

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule; correction.

Effective date: This correcting document is effective March 12, 2013. Applicability Date: This correcting document is applicable to discharges on or after October 1, 2012.

42 CFR Parts 412, 413, 424, and 476

Summary

This document corrects technical errors in the correcting document that appeared in the October 3, 2012 Federal Register entitled “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Correction.”

2012-11-09; vol. 77 # 218 - Friday, November 9, 2012

77 FR 67450 - Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Bad Debt Reductions for All Medicare Providers

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-26903
RIN	0938-AR13
	CMS-1352-F

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule.

Effective Date: These regulations are effective on January 1, 2013. Applicability Date: The regulations setting forth the reductions in Medicare bad debt pursuant to section 3201 of the Middle Class Tax Extension and Job Creation Act of 2012 (Pub. L. 112-96) are applicable for cost reporting periods beginning October 1, 2012.

42 CFR Parts 413 and 417

Summary

This final rule updates and makes revisions to the end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2013. This rule also sets forth requirements for the ESRD quality incentive program (QIP), including for payment year (PY) 2015 and beyond. In addition, this rule implements changes to bad debt reimbursement for all Medicare providers, suppliers, and other entities eligible to receive Medicare payment for bad debt and removes the cap on bad debt reimbursement to ESRD facilities. (See the Table of Contents for a listing of the specific issues addressed in this final rule.)

2012-10-29; vol. 77 # 209 - Monday, October 29, 2012

77 FR 65495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-26505
RIN	0938-AR12
	CMS-1588-CN3

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule; correction.

Effective Date: October 26, 2012.

42 CFR Parts 412, 413, 424, and 476

Summary

This document corrects technical errors that appeared in the final rule that appeared in the August 31, 2012 Federal Register entitled “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers.”

2012-10-23; vol. 77 # 205 - Tuesday, October 23, 2012

77 FR 64755 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 2; Corrections

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-25975
RIN	-0938-AQ84
	CMS-0044-CN2

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule; correction.

Effective Date: This document is effective on November 12, 2012, except that the correction to instruction 8.NN (77 FR 54149) is effective October 23, 2012.

42 CFR Parts 412, 413, and 495

Summary

This document corrects technical errors and typographical errors in the final rule entitled “Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 2” which appeared in the September 4, 2012 issue of the Federal Register .

2012-10-03; vol. 77 # 192 - Wednesday, October 3, 2012

77 FR 60315 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-24307
RIN	0938-AR12
	CMS-1588-CN2

DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services

Final rule; correction.

Effective Date: October 1, 2012.

42 CFR Parts 412, 413, 424, and 476

Summary

This document corrects technical errors in the final rule that appeared in the August 31, 2012 Federal Register entitled “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers.”

42 CFR 413.302 - Definitions.

CFR Toolbox

Law about... Articles from Wex

Get Involved

Find a Lawyer