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42 U.S.C. § 1395n — Repealed. Pub. L. 101–234, title I, § 102(a), Dec. 13, 1989, 103 Stat. 1980

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42 U.S.C. § 1395n — Repealed. Pub. L. 101–234, title I, § 102(a), Dec. 13, 1989, 103 Stat. 1980

### Statutory Notes Section, act Aug. 14, 1935, ch. 531, title XVIII, § 1817A, as added July 1, 1988, Pub. L. 100–360, title I, § 112(a), 102 Stat. 698, provided for establishment and operation of Federal Hospital Insurance Catastrophic Coverage Reserve Fund. #### Effective Date of Repeal Repeal effective Jan. 1, 1990, see section 102(d)(1) of Pub. L. 101–234, set out as a note under [section 59B of Title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section59B&num=0&edition=prelim), Internal Revenue Code. #### Adjustments for Interest Lost Due to Delay of Transfers to Reserve Fund During 1989 Pub. L. 100–360, title I, § 112(b), July 1, 1988, 102 Stat. 699, which directed Secretary of the Treasury, in July of 1990, to calculate interest lost to Federal Hospital Insurance Catastrophic Coverage Reserve Fund due to lag between outlays (attributable to amendments made by Pub. L. 100–360) from Federal Hospital Insurance Trust Fund during 1989 and transfers made to such Reserve Fund to cover such outlays, and provided that appropriations under subsection (a)(2) of this section include amount so calculated, was repealed by Pub. L. 101–234, title I, § 102(a), Dec. 13, 1989, 103 Stat. 1980.

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Source file: Laws/federal/codes/united-states-code/title-42/section-1395n-repealed-pub-l-101234-title-i-102-a-dec-13-1989-103-stat-1980--2731b29306.md
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Source location: Title 42, Chapter 7, § 1395n; chapter-007-social-security.md

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Federal law — U.S. Code and appendices · legal_authorities

26 U.S.C. § 59B — Repealed. Pub. L. 101–234, title I, § 102(a), Dec. 13, 1989, 103 Stat. 1980]

### Statutory Notes Section, added Pub. L. 100–360, title I, § 111(a), July 1, 1988, 102 Stat. 690, provided for imposition of a supplemental medicare premium. #### Effective Date of Repeal Pub. L. 101–234, title I, § 102(d), Dec. 13, 1989, 103 Stat. 1981, provided that: “(1) In general.—Except as provided in this subsection, the provisions of this section [repealing [section 1395i–1a of Title 42](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395i–1a&num=0&edition=prelim), The Public Health and Welfare, enacting provisions set out as notes under [section 6050F of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section6050f&num=0&edition=prelim) and [section 1395t of Title 42](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395t&num=0&edition=prelim), and repealing provisions set out as a note under [section 1395i–1a of Title 42](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395i–1a&num=0&edition=prelim)] shall take effect January 1, 1990. “(2) Repeal of supplemental medicare premium.—The repeal of section 111 of MCCA [Pub. L. 100–360, which enacted this section, amended [section 6050F of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section6050f&num=0&edition=prelim), and enacted provisions set out as notes below] shall apply to taxable years beginning after December 31, 1988.” #### Effective Date Pub. L. 100–360, title I, § 111(e), July 1, 1988, 102 Stat. 698, which provided that the enactment of this section and the amendment of [section 6050F of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section6050f&num=0&edition=prelim) applied to taxable years beginning after December

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395dd — Definitions

For purposes of this subchapter— **(a) Spell of illness** The term “spell of illness” with respect to any individual means a period of consecutive days— (1) beginning with the first day (not included in a previous spell of illness) (A) on which such individual is furnished inpatient hospital services, inpatient critical access hospital services or extended care services, and (B) which occurs in a month for which he is entitled to benefits under part A, and (2) ending with the close of the first period of 60 consecutive days thereafter on each of which he is neither an inpatient of a hospital or critical access hospital nor an inpatient of a facility described in [section 1395i–3(a)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395i–3/a/1&num=0&edition=prelim) or subsection (y)(1). **(b) Inpatient hospital services** The term “inpatient hospital services” means the following items and services furnished to an inpatient of a hospital and (except as provided in paragraph (3)) by the hospital— (1) bed and board; (2) such nursing services and other related services, such use of hospital facilities, and such medical social services as are ordinarily furnished by the hospital for the care and treatment of inpatients, and such drugs, biologicals, supplies, appliances, and equipment, for use in the hospital, as are ordinarily furnished by such hospital for the care and treatment of inpatients; and (3) such other diagnostic or therapeutic items or services, furnished by the hospital or by others under arrangements with them made by the hospital, as are ordinarily furnished to inpatients either by such hospital or by others under such arrangements; (4) medical or surgical services provided by a physician, resident, or intern

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395j — Conditions of and limitations on payment for services

**(a) Requirement of requests and certifications** Except as provided in subsections (d) and (g) and in [section 1395mm of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395mm&num=0&edition=prelim), payment for services furnished an individual may be made only to providers of services which are eligible therefor under [section 1395cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395cc&num=0&edition=prelim) and only if— (1) written request, signed by such individual, except in cases in which the Secretary finds it impracticable for the individual to do so, is filed for such payment in such form, in such manner, and by such person or persons as the Secretary may by regulation prescribe, no later than the close of the period ending 1 calendar year after the date of service; (2) a physician, or, in the case of services described in subparagraph (B), a physician, or a nurse practitioner, a clinical nurse specialist, or a physician assistant (as those terms are defined in [section 1395x(aa)(5) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa/5&num=0&edition=prelim)) who does not have a direct or indirect employment relationship with the facility but is working in collaboration with a physician,,11 So in original. or, in the case of services described in subparagraph (C), a physician, a nurse practitioner or clinical nurse specialist (as such terms are defined in [section 1395x(aa)(5) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa/5&num=0&edition=prelim)) who is working in accordance with State law, or a physician assistant (as defined in [section 1395x(aa)(5) of this title](https://usc

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42 U.S.C. § 1395w — Payment of benefits

**(a) Amounts** Except as provided in [section 1395mm of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395mm&num=0&edition=prelim), and subject to the succeeding provisions of this section, there shall be paid from the Federal Supplementary Medical Insurance Trust Fund, in the case of each individual who is covered under the insurance program established by this part and incurs expenses for services with respect to which benefits are payable under this part, amounts equal to— (1) in the case of services described in [section 1395k(a)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395k/a/1&num=0&edition=prelim)—80 percent of the reasonable charges for the services; except that (A) an organization which provides medical and other health services (or arranges for their availability) on a prepayment basis (and either is sponsored by a union or employer, or does not provide, or arrange for the provision of, any inpatient hospital services) may elect to be paid 80 percent of the reasonable cost of services for which payment may be made under this part on behalf of individuals enrolled in such organization in lieu of 80 percent of the reasonable charges for such services if the organization undertakes to charge such individuals no more than 20 percent of such reasonable cost plus any amounts payable by them as a result of subsection (b), (B) with respect to items and services described in [section 1395x(s)(10)(A) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/s/10/A&num=0&edition=prelim), the amounts paid shall be 100 percent of the reasonable charges for such items and services, (C) with respect to expenses incurred for those physicians

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395n — Procedure for payment of claims of pro-

Page 3164 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395n (3) Funding For purposes of implementing this section, the Secretary shall provide for the transfer, from the Federal Supplementary Medical In- surance Trust Fund under section 1395t of this title, to the Centers for Medicare & Medicaid Services Program Management Account, for each of fiscal years 2014 through 2018, $4,000,000, and for each of fiscal years 2019 through 2023, $3,000,000. Amounts transferred under the preceding sentence shall remain available until expended. (i) Transitional rule During the period beginning on April 1, 2014, and ending on December 31, 2016, with respect to advanced diagnostic laboratory tests under this part, the Secretary shall use the methodologies for pricing, coding, and coverage in effect on the day before April 1, 2014, which may include cross-walking or gapfilling methods. (Aug. 14, 1935, ch. 531, title XVIII, § 1834A, as added Pub. L. 113–93, title II, § 216(a), Apr. 1, 2014, 128 Stat. 1053; amended Pub. L. 116–94, div. N, title I, § 105(a), Dec. 20, 2019, 133 Stat. 3100; Pub. L. 116–136, div. A, title III, § 3718, Mar. 27, 2020, 134 Stat. 425; Pub. L. 117–71, § 4, Dec. 10, 2021, 135 Stat. 1507; Pub. L. 117–286, § 4(a)(251), Dec. 27, 2022, 136 Stat. 4333; Pub. L. 117–328, div. FF, title IV, § 4114, Dec. 29, 2022, 136 Stat. 5901; Pub. L. 118–22, div. B, title II, § 502, Nov. 17, 2023, 137 Stat. 123; Pub. L. 118–83, div. B, title II, § 221, Sept. 26, 2024, 138 Stat. 1538.) Editorial Notes AMENDMENTS 2024—Subsec. (a)(1)(B)(i). Pub. L. 118–83, § 221(b)(1), substituted ‘‘2025’’ for ‘‘2024’’. Subsec. (a)(1)(B)(ii). Pub. L. 118–83, § 221(b)(2), sub- stituted ‘‘2026’’ for ‘‘2025’’ in two places. Subsec. (b)(3)(A). Pub. L. 118–83, § 221(a)(1)

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