federal_register: 05-17175

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05-17175 Medicare Program; Prior Determination for Certain Items and Services Proposed Rule Section 938 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires the Secretary to establish a process for Medicare contractors to provide eligible participating physicians and beneficiaries with a determination of coverage relating to medical necessity for certain physicians' services before the services are furnished. This rule is intended to afford the physician and beneficiary the opportunity to know the financial liability for a service before expenses are incurred. This proposed rule would establish reasonable limits on physicians' services for which a prior determination of coverage may be requested and discusses generally our plans for establishing the procedures by which those determinations may be obtained. 2005-08-30 2005 8 https://www.federalregister.gov/documents/2005/08/30/05-17175/medicare-program-prior-determination-for-certain-items-and-services https://www.govinfo.gov/content/pkg/FR-2005-08-30/pdf/05-17175.pdf Health and Human Services Department; Centers for Medicare & Medicaid Services 221,45 Section 938 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires the Secretary to establish a process for Medicare contractors to provide eligible participating physicians and beneficiaries with a determination of...  

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