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*Much of this article appears in Chapter 157 in Norton Bankruptcy Law and Practice 2d
published by the West Group and appears with their permission.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, P.L. 108-173
Enacted December 8, 2003 § 201, 117 Stat. 2176, (42 USCS § 1395w-21 note). Currently, any reference to "Medicare Advantage" or "MA" is deemed to include a reference to "Medicare + Choice" until the Secretary of Health and Human Services provides for an appropriate transition in the use of the terms, which transition is to be fully completed for all materials for plan years beginning not later than January 1, 2006. The Medicare Advantage program retains many of the same provisions in the M+C program such as the eligibility, enrollment, grievance and appeals provisions. The Medicare Advantage program gives beneficiaries more choices among health plans and most everyone who has Medicare Parts A and B is eligible.
See, e.g. 42 U.S.C. § 1395x(e) and 42 C.F.R. pt. 482-498.
42 U.S.C. §§ 1395x(e) and 1395bb.
42 U.S.C. § 1395cc.
See 42 U.S.C. § 1395y(e).
42 U.S.C. § 1395a(b)(1).
42 U.S.C. § 1395a(b)(4).
42 USC §§ 1396-1986s.
"Introducing CMS" @ http://CMS.hhs.gov/about/reorg.asp
Because of the recentness of this change and the fact that most of the existing case law refers to HCFA rather than CMS, this article has not changed all the references to HCFA to reflect its new name. 42 U.S.C. §§ 1395h and 1395u. See, generally 42 C.F.R. pt. 421. 42 U.S.C. § 1395h.
42 C.F.R. § 434.10(a)-(d).
42 U.S.C. § 1395 ww(g).
www.medpac.gov/publications/other_reports/Dec05_payment_basic_LTCH.pdf.
42 U.S.C. § 1395ww(d)(3)(D).
42 U.S.C. §§ 1395ww(d)(3)(D), (d)(5)(A) and (d)(5)(B).
42 C.F.R. § 419.31.
42 C.F.R. § 419.21 and 419.22.
42 C.F.R. § 413.333.
42 C.F.R. § 413.335.
www.medpac.gov/publications/other_reports/Dec05_payment_basic_IRF.pdf.
www.medpac.gov/publications/other_reports/Dec05_payment_basic_HHA.pdf.
www.medpac.gov/publications/other_reports/Dec05_payment_basic_psych.pdf.
Cost-Based Payments - Medicare Part A § 15.04[6] in National Health Lawyers Association, Health Law Practice Guide (1993).
