§417.546. Physicians' services and other Part B supplier services furnished under arrangements.
42 C.F.R. § 417.546
General principle. The amount paid by an HMO or CMP for physicians' services and other Part B supplier services furnished under arrangements is an allowable cost to the extent it is reasonable. Costs are considered reasonable if they—
Do not exceed those that a prudent and cost-conscious buyer would incur to purchase those services; and
Are comparable to costs incurred for similar services furnished by similar physicians or other suppliers in the same or a similar geographic area.
Notes, amendments, and revision history
Amendments
[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993; 60 FR 34887, July 5, 1995; 60 FR 45372, Aug. 31, 1995]
Source
Source: 50 FR 1346, Jan. 10, 1985, unless otherwise noted.
Authority
Authority: 42 U.S.C. 1302 and 1395hh, and 300e, 300e-5, and 300e-9, and 31 U.S.C. 9701.
Amendments
[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993; 60 FR 34887, July 5, 1995; 60 FR 45372, Aug. 31, 1995]