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Code of Federal Regulations (Last Updated: July 5, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B - Medicare Program |
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Part 417 - Health Maintenance Organizations, Competitive Medical Plans, and Health Care Prepayment Plans |
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Subpart O - Medicare Payment: Cost Basis |
§ 417.533 - Part B carrier responsibilities.
Latest version.
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§ 417.533 Part B carrier responsibilities.
In paying for Part B services furnished to its enrollees by suppliers, the HMO or CMP must -
(a) Determine the eligibility of individuals to receive those services through the HMO or CMP;
(b) Make proper coverage decisions and appropriate payment as authorized under § 421.200 of this chapter for the services for which its Medicare enrollees are eligible; and
(c) Carry out any other procedures that CMS may require.
[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993; 60 FR 46230, Sept. 6, 1995]