Medicare Administrative Costs: Hearings Before the Subcommittee on Oversight of the Committee on Ways and Means, House of Representatives, Ninety-fourth Congress, Second Session, August 2 and 27, 1976
U.S. Government Printing Office, 1976 - Medical care, Cost of - 239 pages
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accordance accounting activities administrative costs agency agree agreement allowable amount approval Association audit authorized basis benefits bill Blue Cross Blue Cross plans Blue Shield budget Bureau carriers changes charge claims committee concerned CONGRESS contract contractors costs covered determined developed direct effective established executive expenses Federal final fiscal functions funds going Government Health Insurance hearing hospital increase individual instructions interest Intermediary issues letter LIBRARY means Medicare Medicare program meeting million necessary negotiations notice operations organizations paid paragraph payment percent performance period Plan prior problems procedures processing proposed providers question reasonable record regulations reimbursement reports representatives responsibility result role Secretary Social Security Social Security Administration specific staff standards STARK statement subcontract submit term things tion TRESNOWSKI utilization vice president
Page 220 - Contractor shall proceed diligently with the performance of the contract and in accordance with the Contracting Officer's decision. (b) This "Disputes" clause does not preclude consideration of law questions in connection with decisions provided for in paragraph (a) above : Provided, That nothing in this contract shall be construed as making final the decision of any administrative official, representative, or board on a question of law.
Page 194 - The decision of the Secretary or his duly authorized representative for the determination of such appeals shall be final and conclusive unless determined by a court of competent Jurisdiction to have been fraudulent, or capricious, or arbitrary, or so grossly erroneous as necessarily to imply bad faith, or not supported by substantial evidence.
Page 199 - Disputes" clause of this contract, (2) litigation or the settlement of claims arising out of the performance of this contract, or (3) costs and expenses of this contract as to which exception has been taken by the Comptroller General or any of his duly authorized representatives, shall continue until such appeals, litigation, claims, or exceptions have been disposed of.
Page 168 - No disbursing officer shall, in the absence of gross negligence or intent to defraud the United States, be liable with respect to any payment by him under this...
Page 180 - Except as otherwise provided in this contract, any dispute concerning a question of fact arising under this contract which is not disposed of by agreement shall be decided by the Contracting Officer, who shall reduce his decision to writing and mail or otherwise furnish a copy thereof to the Contractor.
Page 202 - Contractor, was then of said Corporation; that said Contract was duly signed for and in behalf of said Corporation by authority of its governing body, and is within the scope of its corporate powers.
Page 168 - No certifying or disbursing officer shall be held liable for any amount certified or paid by him in good faith to any person where the recovery of such amount is waived under subsection (c) of this section or has been begun but cannot be completed under subsection (a) of this section.
Page 183 - I know his signature, and his signature thereto is genuine; and that said bond was duly signed, sealed, and attested for and in behalf of said corporation by authority of its governing body. ["Corporate"!