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Current as of January 02, 2025 | Updated by Findlaw Staff
(a) The limitation on the charges and FEHB benefit payments for inpatient hospital services apply to inpatient hospital services which are:
(1) Covered under both Medicare part A and the retired enrolled individual's FEHB plan; and
(2) Supplied to a retired enrolled individual who does not have Medicare part A; and
(3) Provided by hospital providers who have in force participation agreements with the Secretary of Health and Human Services (HHS) consistent with sections 1814(a) and 1866 of the Social Security Act, and receive Medicare part A payments in accordance with the diagnosis related group (DRG) based prospective payment system (PPS).
(b) The limitation on the charges and FEHB benefit payments for physician services apply to physician services, (as defined in section 1848(j) of the Social Security Act), which are:
(1) Covered under both Medicare part B and the retired enrolled individual's FEHB plan; and
(2) Supplied to a retired enrolled individual who does not have Medicare part B.
Cite this article: FindLaw.com - Code of Federal Regulations Title 5. Administrative Personnel § 5.890.903 Covered services - last updated January 02, 2025 | https://codes.findlaw.com/cfr/title-5-administrative-personnel/cfr-sect-5-890-903/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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