---
kind: "section"
citation: "42 C.F.R. § 422.318"
title: "42"
number: "422.318"
heading: "Special rules for coverage that begins or ends during an inpatient hospital stay."
url: "https://uscodex.org/cfr/42/422.318"
---

# §422.318. Special rules for coverage that begins or ends during an inpatient hospital stay.

- (a) **Applicability.** This section applies to inpatient services in a “subsection (d) hospital” as defined in section 1886(d)(1)(B) of the Act, a psychiatric hospital described in [section 1886(d)(1)(B)(i)](/cfr/42/1886.md?p=d-1-B-i) of the act, a rehabilitation hospital described in section 1886(d)(1)(B)(ii) of the Act, a distinct part rehabilitation unit described in the matter following clause (v) of section 1886(d)(1)(B) of the Act, or a long-term care hospital (described in [section 1886(d)(1)(B)(iv)](/cfr/42/1886.md?p=d-1-B-iv)).
- (b) **Coverage that begins during an inpatient stay.** If coverage under an MA plan offered by an MA organization begins while the beneficiary is an inpatient in one of the facilities described in [paragraph (a)](#a) of this section—
  - (1) Payment for inpatient services until the date of the beneficiary's discharge is made by the previous MA organization or original Medicare, as appropriate;
  - (2) The MA organization offering the newly-elected MA plan is not responsible for the inpatient services until the date after the beneficiary's discharge; and
  - (3) The MA organization offering the newly-elected MA plan is paid the full amount otherwise payable under this subpart.
- (c) **Coverage that ends during an inpatient stay.** If coverage under an MA plan offered by an MA organization ends while the beneficiary is an inpatient in one of the facilities described in [paragraph (a)](#a) of this section—
  - (1) The MA organization is responsible for the inpatient services until the date of the beneficiary's discharge;
  - (2) Payment for those services during the remainder of the stay is not made by original Medicare or by any succeeding MA organization offering a newly-elected MA plan; and
  - (3) The MA organization that no longer provides coverage receives no payment for the beneficiary for the period after coverage ends.

## Notes

### Source

Source: 70 FR 4729, Jan. 28, 2005, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302, 1306, 1395w-21 through 1395w-28, and 1395hh.

### Source

Source: 63 FR 18134, Apr. 14, 1998, unless otherwise noted.