CMS Rulings

CMS Rulings are decisions of the Administrator that serve as precedent final opinions and orders and statements of policy and interpretation. They provide clarification and interpretation of complex or ambiguous provisions of the law or regulations relating to Medicare, Medicaid, Utilization and Quality Control Peer Review, private health insurance, and related matters.

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Title	Subject
Title HCFA Ruling 95-1	Subject Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) REQUIREMENTS FOR DETERMINING LIMITATION ON LIABILITY OF A MEDICARE BENEFICIARY, PROVIDER, PRACTITIONER, OR OTHER SUPPLIER FOR CERTAIN SERVICES AND ITEMS FOR WHICH MEDICARE PAYMENT IS...
Title HCFA Ruling 96-2	Subject Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) REQUIREMENTS FOR DETERMINING LIMITATION ON LIABILITY OF A MEDICARE BENEFICIARY, SUPPLIER, PRACTITIONER, OR OTHER SUPPLIER FOR PAP SMEARS AND MAMMOGRAPHY SERVICES FOR WHICH MEDICARE P...
Title HCFA Ruling 98-1	Subject Medicare Supplementary Medical Insurance (Part B) THE ADMINISTRATIVE APPEALS PROCESS FOR PHYSICIANS, NON-PHYSICIAN PRACTITIONERS, AND ENTITIES THAT RECEIVE REASSIGNED BENEFITS AND THAT ARE NOT PROVIDED APPEAL RIGHTS UNDER 42 CFR PART 498
Title CMS Ruling 01-01	Subject The National and Local Coverage Determination Review Process for an Individual with Standing as Defined in Section 522 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protections Act of 2000.
Title CMS-1536-R	Subject This Ruling sets forth the policy of the CMS concerning the requirements for determining payment made for insertion of astigmatism-conecting intraocular lenses following cataract surgery under the following sections of the Act.
Title HCFA Ruling 97-1	Subject Requirements for determining limitation on liability of a medicare beneficiary, provider, practitioner, or other supplier for partial hospitalization services for which Medicare payment is denied.
Title HCFA Ruling 96-3	Subject Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) REQUIREMENTS FOR DETERMINING LIMITATION ON LIABILITY OF A MEDICARE BENEFICIARY, PROVIDER, PRACTITIONER, OR OTHER SUPPLIER FOR PARENTERAL AND ENTERAL NUTRITION THERAPY, INCLUDING INTR...
Title CMS-1498-R	Subject Hospital Insurance (Part A)Jurisdiction over Appeals of Disproportionate Share Hospital (DSH) Payments, and Recalculations of DSH Payments Following Remands From Administrative Tribunals
Title CMS Ruling 02-01	Subject Changes in Medicare appeals procedures under section 521 of BIPA.
Title CMS-1543-R	Subject Allocation of Donor Acquisition Costs Incurred by Organ Procurement Organizations (OPOs)

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