§ 1395x Definitions
§ 1395y Exclusions from coverage and medicare as secondary payer
§ 1395z Consultation with State agencies and other organizations to develop conditions of participation for providers of services
§ 1395aa Agreements with States
§ 1395bb Effect of accreditation
§ 1395cc Agreements with providers of services; enrollment processes
§ 1395cc-1 Demonstration of application of physician volume increases to group practices
§ 1395cc-2 Provisions for administration of demonstration program
§ 1395cc-3 Health care quality demonstration program
§ 1395cc-4 National pilot program on payment bundling
§ 1395cc-5 Independence at home medical practice demonstration program
§ 1395cc-6 Opioid use disorder treatment demonstration program
§ 1395cc-7 Extension of Acute Hospital Care at Home initiative
§ 1395dd Examination and treatment for emergency medical conditions and women in labor
§ 1395ee Practicing Physicians Advisory Council; Council for Technology and Innovation
§ 1395ff Determinations; appeals
§ 1395gg Overpayment on behalf of individuals and settlement of claims for benefits on behalf of deceased individuals
§ 1395hh Regulations
§ 1395ii Application of certain provisions of subchapter II
§ 1395jj Designation of organization or publication by name
§ 1395kk Administration of insurance programs
§ 1395kk-1 Contracts with medicare administrative contractors
§ 1395kk-2 Expanding availability of Medicare data
§ 1395ll Studies and recommendations
§ 1395mm Payments to health maintenance organizations and competitive medical plans
§ 1395nn Limitation on certain physician referrals
§ 1395oo Provider Reimbursement Review Board
§ 1395pp Limitation on liability where claims are disallowed
§ 1395qq Indian Health Service facilities
§ 1395rr End stage renal disease program
§ 1395rr-1 Medicare coverage for individuals exposed to environmental health hazards
§ 1395ss Certification of medicare supplemental health insurance policies
§ 1395ss-1 Clarification
§ 1395tt Hospital providers of extended care services
§ 1395uu Payments to promote closing or conversion of underutilized hospital facilities
§ 1395vv Withholding payments from certain medicaid providers
§ 1395ww Payments to hospitals for inpatient hospital services
§ 1395xx Payment of provider-based physicians and payment under certain percentage arrangements
§ 1395yy Payment to skilled nursing facilities for routine service costs
§ 1395zz Provider education and technical assistance
§ 1395aaa Contract with a consensus-based entity regarding performance measurement
§ 1395aaa-1 Quality and efficiency measurement
§ 1395bbb Conditions of participation for home health agencies; home health quality
§ 1395ccc Offset of payments to individuals to collect past-due obligations arising from breach of scholarship and loan contract
§ 1395ddd Medicare Integrity Program
§ 1395eee Payments to, and coverage of benefits under, programs of all-inclusive care for elderly (PACE)
§ 1395fff Prospective payment for home health services
§ 1395hhh Health care infrastructure improvement program
§ 1395iii Medicare Improvement Fund
§ 1395jjj Shared savings program
§ 1395lll Standardized post-acute care (PAC) assessment data for quality, payment, and discharge planning

Terms Used In U.S. Code > Title 42 > Chapter 7 > Subchapter XVIII > Part E - Miscellaneous Provisions

  • Adjournment sine die: The end of a legislative session "without day." These adjournments are used to indicate the final adjournment of an annual or the two-year session of legislature.
  • Administration: means the Social Security Administration, except where the context requires otherwise. See 42 USC 1301
  • Allegation: something that someone says happened.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • association: when used in reference to a corporation, shall be deemed to embrace the words "successors and assigns of such company or association" in like manner as if these last-named words, or words of similar import, were expressed. See 1 USC 5
  • Balanced budget: A budget in which receipts equal outlays.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
  • Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • corporation: includes associations, joint-stock companies, and insurance companies. See 42 USC 1301
  • county: includes a parish, or any other equivalent subdivision of a State or Territory of the United States. See 1 USC 2
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Deed: The legal instrument used to transfer title in real property from one person to another.
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • Dependent: A person dependent for support upon another.
  • Devise: To gift property by will.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Donor: The person who makes a gift.
  • Electronic funds transfer: The transfer of money between accounts by consumer electronic systems-such as automated teller machines (ATMs) and electronic payment of bills-rather than by check or cash. (Wire transfers, checks, drafts, and paper instruments do not fall into this category.) Source: OCC
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Escrow: Money given to a third party to be held for payment until certain conditions are met.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Extradition: The formal process of delivering an accused or convicted person from authorities in one state to authorities in another state.
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Fiduciary: A trustee, executor, or administrator.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Forbearance: A means of handling a delinquent loan. A
  • Fraud: Intentional deception resulting in injury to another.
  • Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • hospitalization: include osteopathic practitioners or the services of osteopathic practitioners and hospitals within the scope of their practice as defined by State law. See 42 USC 1301
  • including: when used in a definition contained in this chapter shall not be deemed to exclude other things otherwise within the meaning of the term defined. See 42 USC 1301
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
  • individual: shall include every infant member of the species homo sapiens who is born alive at any stage of development. See 1 USC 8
  • Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. Source: OCC
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Legislative session: That part of a chamber's daily session in which it considers legislative business (bills, resolutions, and actions related thereto).
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • officer: includes any person authorized by law to perform the duties of the office. See 1 USC 1
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • person: means an individual, a trust or estate, a partnership, or a corporation. See 42 USC 1301
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • regulations: means , unless the context otherwise requires, regulations prescribed by the Secretary. See 42 USC 1395hh
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Remand: When an appellate court sends a case back to a lower court for further proceedings.
  • Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
  • Rio Grande Compact: shall mean that certain compact executed on March 18, 1938, by commissioners representing the States of Colorado, New Mexico, and Texas and consented to by the Congress of the United States of America by Act of May 31, 1939 (53 Stat. See 43 USC 620o
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • State: means a State, the District of Columbia, the Commonwealth of Puerto Rico, or any other territory or possession of the United States. See 1 USC 7
  • State: when used in such subchapters (but not in subchapter XVI as in effect pursuant to such amendment after December 31, 1973) includes Puerto Rico, the Virgin Islands, and Guam. See 42 USC 1301
  • States of the Upper Colorado River Basin: shall mean the States of Arizona, Colorado, New Mexico, Utah, and Wyoming. See 43 USC 620o
  • Statute: A law passed by a legislature.
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
  • Treaty with the United Mexican States: shall mean that certain treaty between the United States of America and the United Mexican States, signed at Washington, District of Columbia, February 3, 1944, relating to the utilization of the waters of the Colorado River and other rivers, as amended and supplemented by the protocol dated November 14, 1944, and the understandings recited in the Senate resolution of April 18, 1945, advising and consenting to ratification thereof. See 43 USC 620o
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Trustee: A person or institution holding and administering property in trust.
  • United States: means (but only for purposes of subparagraphs (A) and (B) of this paragraph) the fifty States and the District of Columbia. See 42 USC 1301
  • Uphold: The decision of an appellate court not to reverse a lower court decision.
  • Upper Colorado River Basin Compact: shall mean that certain compact executed on October 11, 1948 by commissioners representing the States of Arizona, Colorado, New Mexico, Utah, and Wyoming, and consented to by the Congress of the United States of America by Act of April 6, 1949 (63 Stat. See 43 USC 620o
  • User fees: Fees charged to users of goods or services provided by the government. In levying or authorizing these fees, the legislature determines whether the revenue should go into the treasury or should be available to the agency providing the goods or services.
  • vehicle: includes every description of carriage or other artificial contrivance used, or capable of being used, as a means of transportation on land. See 1 USC 4
  • Venue: The geographical location in which a case is tried.
  • vessel: includes every description of watercraft or other artificial contrivance used, or capable of being used, as a means of transportation on water. See 1 USC 3
  • whoever: include corporations, companies, associations, firms, partnerships, societies, and joint stock companies, as well as individuals. See 1 USC 1
  • writing: includes printing and typewriting and reproductions of visual symbols by photographing, multigraphing, mimeographing, manifolding, or otherwise. See 1 USC 1