Subchapter XVIII: HEALTH INSURANCE FOR AGED AND DISABLED
Part A: Hospital Insurance Benefits for Aged and Disabled
- Section 1395c: Description of program
- Section 1395d: Scope of benefits
- Section 1395e: Deductibles and coinsurance
- Section 1395f: Conditions of and limitations on payment for services
- Section 1395g: Payments to providers of services
- Section 1395h: Provisions relating to the administration of part A
- Section 1395i: Federal Hospital Insurance Trust Fund
- Section 1395i–1: Authorization of appropriations
- Section 1395i–1a: Repealed. Pub. L. 101–234, title I, § 102(a), Dec. 13, 1989, 103 Stat. 1980
- Section 1395i–2: Hospital insurance benefits for uninsured elderly individuals not otherwise eligible
- Section 1395i–2a: Hospital insurance benefits for disabled individuals who have exhausted other entitlement
- Section 1395i–3: Requirements for, and assuring quality of care in, skilled nursing facilities
- Section 1395i–3a: Protecting residents of long-term care facilities
- Section 1395i–4: Medicare rural hospital flexibility program
- Section 1395i–5: Conditions for coverage of religious nonmedical health care institutional services
Part B: Supplementary Medical Insurance Benefits for Aged and Disabled
- Section 1395j: Establishment of supplementary medical insurance program for aged and disabled
- Section 1395k: Scope of benefits; definitions
- Section 1395l: Payment of benefits
- Section 1395m: Special payment rules for particular items and services
- Section 1395m–1: Improving policies for clinical diagnostic laboratory tests
- Section 1395n: Procedure for payment of claims of providers of services
- Section 1395o: Eligible individuals
- Section 1395p: Enrollment periods
- Section 1395q: Coverage period
- Section 1395r: Amount of premiums for individuals enrolled under this part
- Section 1395s: Payment of premiums
- Section 1395t: Federal Supplementary Medical Insurance Trust Fund
- Section 1395t–1, 1395t–2: Repealed. Pub. L. 101–234, title II, § 202(a), Dec. 13, 1989, 103 Stat. 1981
- Section 1395u: Provisions relating to the administration of part B
- Section 1395v: Agreements with States
- Section 1395w: Appropriations to cover Government contributions and contingency reserve
- Section 1395w–1: Repealed. Pub. L. 105–33, title IV, § 4022(b)(2)(A), Aug. 5, 1997, 111 Stat. 354
- Section 1395w–2: Intermediate sanctions for providers or suppliers of clinical diagnostic laboratory tests
- Section 1395w–3: Competitive acquisition of certain items and services
- Section 1395w–3a: Use of average sales price payment methodology
- Section 1395w–3b: Competitive acquisition of outpatient drugs and biologicals
- Section 1395w–4: Payment for physicians’ services
- Section 1395w–5: Public reporting of performance information
- Section 1395w–6: Empowering beneficiary choices through continued access to information on physicians’ services
Part C: Medicare+Choice Program
- Section 1395w–21: Eligibility, election, and enrollment
- Section 1395w–22: Benefits and beneficiary protections
- Section 1395w–23: Payments to Medicare+Choice organizations
- Section 1395w–24: Premiums and bid amounts
- Section 1395w–25: Organizational and financial requirements for Medicare+Choice organizations; provider-sponsored organizations
- Section 1395w–26: Establishment of standards
- Section 1395w–27: Contracts with Medicare+Choice organizations
- Section 1395w–27a: Special rules for MA regional plans
- Section 1395w–28: Definitions; miscellaneous provisions
- Section 1395w–29: Repealed. Pub. L. 111–152, title I, § 1102(f), Mar. 30, 2010, 124 Stat. 1046
Part D: Voluntary Prescription Drug Benefit Program
- Subpart 1: part d eligible individuals and prescription drug benefits
- Subpart 2: prescription drug plans; pdp sponsors; financing
- Section 1395w–111: PDP regions; submission of bids; plan approval
- Section 1395w–112: Requirements for and contracts with prescription drug plan (PDP) sponsors
- Section 1395w–113: Premiums; late enrollment penalty
- Section 1395w–114: Premium and cost-sharing subsidies for low-income individuals
- Section 1395w–114a: Medicare coverage gap discount program
- Section 1395w–115: Subsidies for part D eligible individuals for qualified prescription drug coverage
- Section 1395w–116: Medicare Prescription Drug Account in the Federal Supplementary Medical Insurance Trust Fund
- Subpart 3: application to medicare advantage program and treatment of employer-sponsored programs and other prescription drug plans
- Section 1395w–131: Application to Medicare Advantage program and related managed care programs
- Section 1395w–132: Special rules for employer-sponsored programs
- Section 1395w–133: State Pharmaceutical Assistance Programs
- Section 1395w–134: Coordination requirements for plans providing prescription drug coverage
- Subpart 4: medicare prescription drug discount card and transitional assistance program
- Subpart 5: definitions and miscellaneous provisions
Part E: Miscellaneous Provisions
- Section 1395x: Definitions
- Section 1395y: Exclusions from coverage and medicare as secondary payer
- Section 1395z: Consultation with State agencies and other organizations to develop conditions of participation for providers of services
- Section 1395aa: Agreements with States
- Section 1395bb: Effect of accreditation
- Section 1395cc: Agreements with providers of services; enrollment processes
- Section 1395cc–1: Demonstration of application of physician volume increases to group practices
- Section 1395cc–2: Provisions for administration of demonstration program
- Section 1395cc–3: Health care quality demonstration program
- Section 1395cc–4: National pilot program on payment bundling
- Section 1395cc–5: Independence at home medical practice demonstration program
- Section 1395cc–6: Opioid use disorder treatment demonstration program.
- Section 1395dd: Examination and treatment for emergency medical conditions and women in labor
- Section 1395ee: Practicing Physicians Advisory Council; Council for Technology and Innovation
- Section 1395ff: Determinations; appeals
- Section 1395gg: Overpayment on behalf of individuals and settlement of claims for benefits on behalf of deceased individuals
- Section 1395hh: Regulations
- Section 1395ii: Application of certain provisions of subchapter II
- Section 1395jj: Designation of organization or publication by name
- Section 1395kk: Administration of insurance programs
- Section 1395kk–1: Contracts with medicare administrative contractors
- Section 1395kk–2: Expanding availability of Medicare data
- Section 1395ll: Studies and recommendations
- Section 1395mm: Payments to health maintenance organizations and competitive medical plans
- Section 1395nn: Limitation on certain physician referrals
- Section 1395oo: Provider Reimbursement Review Board
- Section 1395pp: Limitation on liability where claims are disallowed
- Section 1395qq: Indian Health Service facilities
- Section 1395rr: End stage renal disease program
- Section 1395rr–1: Medicare coverage for individuals exposed to environmental health hazards
- Section 1395ss: Certification of medicare supplemental health insurance policies
- Section 1395ss–1: Clarification
- Section 1395tt: Hospital providers of extended care services
- Section 1395uu: Payments to promote closing or conversion of underutilized hospital facilities
- Section 1395vv: Withholding payments from certain medicaid providers
- Section 1395ww: Payments to hospitals for inpatient hospital services
- Section 1395xx: Payment of provider-based physicians and payment under certain percentage arrangements
- Section 1395yy: Payment to skilled nursing facilities for routine service costs
- Section 1395zz: Provider education and technical assistance
- Section 1395aaa: Contract with a consensus-based entity regarding performance measurement
- Section 1395aaa–1: Quality and efficiency measurement
- Section 1395bbb: Conditions of participation for home health agencies; home health quality
- Section 1395ccc: Offset of payments to individuals to collect past-due obligations arising from breach of scholarship and loan contract
- Section 1395ddd: Medicare Integrity Program
- Section 1395eee: Payments to, and coverage of benefits under, programs of all-inclusive care for elderly (PACE)
- Section 1395fff: Prospective payment for home health services
- Section 1395ggg: Omitted
- Section 1395hhh: Health care infrastructure improvement program
- Section 1395iii: Medicare Improvement Fund
- Section 1395jjj: Shared savings program
- Section 1395kkk: Repealed. Pub. L. 115–123, div. E, title XI, § 52001(a), Feb. 9, 2018, 132 Stat. 298
- Section 1395kkk–1: Repealed. Pub. L. 115–123, div. E, title XI, § 52001(b)(2), Feb. 9, 2018, 132 Stat. 298
- Section 1395lll: Standardized post-acute care (PAC) assessment data for quality, payment, and discharge planning