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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 H - Health Care Infrastructure and Model Programs |
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Part 512 - Episode Payment Model |
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Subpart G - Waivers |
§ 512.620 - Waiver of deductible and coinsurance that otherwise apply to reconciliation payments or repayments.
Latest version.
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§ 512.620 Waiver of deductible and coinsurance that otherwise apply to reconciliation payments or repayments.
(a) Waiver of deductible and coinsurance. CMS waives the requirements of sections 1813 and 1833(a) of the Act for Medicare Part A and Part B payment systems only to the extent necessary to make reconciliation payments or receive repayments based on the NPRA that reflect the episode payment methodology under the final payment model for EPM participant hospitals.
(b) Reconciliation payments or repayments. Reconciliation payments or repayments do not affect the beneficiary cost-sharing amounts for the Medicare Part A and Part B services provided under an EPM.