Opinion ID: 490603
Heading Depth: 2
Heading Rank: 1

Heading: Medicare Program

Text: 2 Under the Medicare Act, 42 U.S.C. Secs. 1395-1395zz (1982 & Supp.1985), hospitals that qualify as providers of medical services must furnish medical care to Program beneficiaries. In return, the Program reimburses the provider for the reasonable cost of the services, as defined by the Act and regulations promulgated thereunder. Statutory responsibility for administering the Program resides in the Secretary of Health and Human Services. The Secretary, however, has delegated the responsibility to the Health Care Financing Administration. 3 The Secretary reimburses providers under the Program through Intermediaries--public or private organizations nominated by a provider for the purpose of contracting with the Secretary in order to determine the amounts payable under the Program. Periodically, the Secretary publishes and updates a Provider Reimbursement Manual (PRM) through which he communicates his position and policies to the contractual intermediary for implementation of the Medicare regulations.