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医疗补助计划;医疗救助的第三方责任;熟练专业医务人员及辅助人员的联邦财政参与率;以及州财政参与份额的来源——医疗保健财务管理局。拟议规则。

Medicaid program; third party liability for medical assistance; FFP rates for skilled professional medical personnel and supporting staff; and sources of state share of financial participation--HCFA. Proposed rules.

出版信息

Fed Regist. 1984 Jun 4;49(108):23078-85.

Abstract

These proposed regulations would--(1) Broaden the scope of services for which a State must collect from third parties the cost of medical assistance furnished to Medicaid recipients, remove the specific requirements for the terms of cooperative agreements for third party collections, and revise the methods of paying claims involving third party liability; (2) Clarify criteria used in determining whether skilled professional medical personnel and supporting staff involved in the administration of the Medicaid program quality for 75 percent Federal matching; and (3) Clarify policy to permit public and private donations to be used as a State's share of financial participation in the entire Medicaid program, instead of only for training expenditures. The proposed amendments would clarify policy and reduce program expenditures.

摘要

这些拟议的法规将

(1) 扩大各州必须向第三方收取为医疗补助受助人提供医疗援助费用的服务范围,取消第三方收款合作协议条款的具体要求,并修订涉及第三方责任的理赔支付方式;(2) 明确用于确定参与医疗补助计划管理的专业医疗人员和辅助人员是否符合75%联邦配套资金条件的标准;(3) 明确政策,允许将公共和私人捐赠用作州在整个医疗补助计划中财政参与份额,而不仅仅用于培训支出。拟议的修正案将明确政策并减少计划支出。

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