Because in this final rule we are deleting the specific list of programs and replacing it with a general requirement that the program must be recognized by a national or State licensing approving body, our responses to the comments on the specialties note whether or not we consider the specialty as an approved nursing and allied program, and do not address whether we should add the specialty to or delete the specialty from a list of approved programs. In determining reasonable costs for hospitals, the amount of allowable bad debt as defined in paragraph e of this section is reduced: i For cost reporting periods beginning during fiscal year 1998, by 25 percent; ii For cost reporting periods beginning during fiscal year 1999, by 40 percent; iii For cost reporting periods beginning during fiscal year 2000, by 45 percent; and iv For cost reporting periods beginning during fiscal years 2001 through 2012, by 30 percent. A provider-based entity comprises both the specific physical facility that serves as the site of services of a type for which payment could be claimed under the Medicare or Medicaid program, and the personnel and equipment needed to deliver the services at that facility. D The hospital in which the facility or organization is physically located is in a rural area as defined in § 412. Payment for screening mammography performed by hospitals on an outpatient basis.
Two examples of these costs are the purchase of textbooks for resale to students and the provision of housing or room and board in exchange for an additional fee. The retroactive payments will take fully into account the costs that were actually incurred and settle on an actual, rather than on an estimated basis. District Court for the Southern District of Mississippi ruled that the Secretary's offset of nursing and allied health costs of State appropriations was appropriate. The provider may create a program leading to a degree in which instruction in general academic requirements is provided by a college or university and subsequent specialized classroom instruction and clinical training are given by the provider. By analysis of such statement in light of the principles of reimbursement, the contractor will compute an appropriate rate of payment. Internet users can access the database by using the World Wide Web. While, for the most part, the Start Printed Page 3372costs of these programs would continue to be paid under the generally applicable rules set forth at § 413.
B Accrued liability related to contributions to a funded deferred compensation plan must be liquidated within 1 year after the end of the cost reporting period in which the liability is incurred. We believe that the language included in the Committee Report that accompanied Public Law 101-508 supports this distinction between total allowable costs for provider-operated and nonprovider-operated programs. Another commenter believed that this requirement unnecessarily restricts new programs at nonprovider sites. That is, we proposed to retain the provisions in existing regulations under § 413. Determining the per treatment payment amount. Subject to the provisions of § 413. Employee fringe benefits, such as hospitalization and personnel health programs, are not considered to be courtesy allowances.
We note that this requirement that the nursing and allied health program be accredited by one of these approving bodies is simply one of the requirements under the general payment rule under § 413. Although some Start Printed Page 3369provider-incurred overhead costs directly related to the cost of the students would be allowable, overhead costs incurred by the related organization generally would not be considered allowable. Bad debts are amounts considered to be uncollectible from accounts and notes receivable that were created or acquired in providing services. The facility or organization director or individual responsible for daily operations at the entity - A Maintains a reporting relationship with a manager at the main provider that has the same frequency, intensity, and level of accountability that exists in the relationship between the main provider and its existing departments; and B Is accountable to the governing body of the main provider, in the same manner as any department head of the provider. The written agreement must specify the total cost of the training program at the nonhospital site, and the amount the hospital will incur at least 90 percent of the total , and must indicate the portion of the amount the hospital will incur that reflects residents' salaries and fringe benefits and travel and lodging where applicable , and the portion of this amount that reflects teaching physician compensation.
We are clarifying § 413. In calculating inpatient days, inpatient days in any distinct part of the hospital furnishing a hospital level of care are included and nursery days are excluded. We believe that, in these situations, the community has not undertaken to finance the training of health professionals; the provider has merely restructured its provider-operated program to meet certain State or accrediting requirements. Free-standing facility means an entity that furnishes health care services to Medicare beneficiaries and that is not integrated with any other entity as a main provider, a department of a provider, remote location of a hospital, satellite facility, or a provider-based entity. In such cases, it is equitable that reasonable compensation for the services furnished to be an allowable cost. On or after July 1, 1986, and before July 1, 1987, the weighting factor for a graduate of a foreign medical school who was in a residency program both before and after July 1, 1986 but who does not meet the requirements set forth in paragraph a of this section is. Further, it specified that costs incurred by a provider associated with the classroom portion of the program could be allowable if they did not constitute a redistribution of nonprovider costs to the provider, the provider received a benefit for the support furnished, and the cost of the provider's support was less than the cost the provider would incur in operating its own program.
For example, at § 413. Another commenter stated that we did not provide any rationale for changing our policy on grants and donations. C Enhance the quality of health care at the provider. While the provider may incur some costs associated with its provision of clinical training to students enrolled in a nearby institution, the provider would also gain in return. One commenter requested that the rule should be based on cost reports filed after the effective date of the final rule or allow providers to reopen their fiscal year 1989 cost reports to include nursing and allied health education costs.
Also, the provider determines in what manner its students will accomplish the course work that will allow them to be accredited. If application of this criterion requires either board to have more than four common board members, the hospital will meet this criterion by having at least four common board members. The costs of the following educational activities incurred by a provider but not operated by that provider are recognized only as normal operating costs and paid in accordance with the reimbursement principles specified in Part 412 of this subchapter. This policy was not intended to expand the range of items and services for which a provider could claim payment. Medicare states that providers of services will be paid the reasonable cost of services furnished to beneficiaries. As discussed in detail above, we believe that Congress intended to support nursing and allied health education programs operated by hospitals only until the community undertakes the costs of the programs itself. The specific comments and our responses are set forth below following each section describing the specific provisions of the proposed rule.
Provider-based status means the relationship between a main provider and a provider-based entity or a department of a provider, remote location of a hospital, or satellite facility, that complies with the provisions of this section. We also proposed that only those nursing and allied health education programs listed in the regulations may be paid as approved educational activities. Determining payment amounts: Ancillary services. Response: The existing regulations at § 413. The examples we list are: the Commission on Accreditation of Allied Health Education Programs; the National League of Nursing Accrediting Commission; the Association for Clinical Pastoral Education, Inc. The amounts allowed are not to exceed those paid others for similar work.
. A qualifying entity will not be eligible for incentive payments for a reduction in the base number of residents if the reduction is a result of the entity rotating residents to another hospital that is not a part of its voluntary residency reduction plan. Payment for home health agency services. Other tools to assist the reader in navigating the document include a crosswalk of reorganized text for § 413. However, these meetings are not formal, didactic classroom instruction. We proposed to amend § 413.