§417.552. Cost apportionment: General provisions.
42 C.F.R. § 417.552
Basic rule. The HMO or CMP must apportion its total allowable direct and indirect costs among its Medicare enrollees, its other enrollees, and its nonenrolled patients—
In accordance with this subpart; and
Using methods approved by CMS.
Purpose of apportionment. The purpose of apportionment is to ensure that—
The cost of services furnished to Medicare enrollees is not borne by other enrollees and nonenrolled patients; and
The cost of the services furnished to other enrollees and nonenrolled patients is not borne by Medicare.
Notes, amendments, and revision history
Amendments
[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993; 60 FR 46230, Sept. 6, 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 46230, Sept. 6, 1995]