Fed Regist. 1990 Jan 16;55(10):1423-34.
This final rule implements certain Medicaid State plan requirements and other provisions relating to State third party liability (TPL) programs. Its provisions deal with: (1) The integration of a State's pursuit of third party claims with its Mechanized Claims Processing and Information Retrieval System; (2) exceptions to the cost avoidance method of claims payment in TPL situations; and (3) provider restrictions and penalties related to attempts at collection of cost sharing or portions of those amounts from Medicaid recipients when TPL has been established. These regulations implement portions of section 9503 of the Consolidated Omnibus Budget Reconciliation Act of 1985.
本最终规则实施了某些医疗补助州计划要求以及与州第三方责任（TPL）计划相关的其他条款。其条款涉及：（1）州对第三方索赔的追偿与其机械化索赔处理和信息检索系统的整合；（2）TPL情形下索赔支付成本规避方法的例外情况；以及（3）当已确定TPL时，与试图向医疗补助受益人收取成本分摊额或其中部分金额相关的提供者限制和处罚。这些规定实施了1985年《综合预算协调法》第9503节的部分内容。
