Special requirements concerning CHAMPUS and CHAMPVA programs.

1. Law
2. CFR 42
3. Public Health
4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
5. Standards and Certification
6. Provider Agreements and Supplier Approval
7. Essentials of Provider Agreements
8. Special requirements concerning CHAMPUS and CHAMPVA programs.

§ 489.25 Special requirements concerning CHAMPUS and CHAMPVA programs.

For inpatient services, a hospital that participates in the Medicare program must participate in any health plan contracted under 10 U.S.C. 1079 or 1086 (Civilian Health and Medical Program of the Uniformed Services) and under 38 U.S.C. 613 (Civilian Health and Medical Program of the Veterans Administration) and accept the CHAMPUS/CHAMPVA-determined allowable amount as payment in full, less applicable deductible, patient cost-share, and noncovered items. Hospitals must meet the requirements of 32 CFR part 199 concerning program benefits under the Department of Defense. This section applies to inpatient services furnished to beneficiaries admitted on or after January 1, 1987.

[59 FR 32123, June 22, 1994]

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