Medicare Benefit Policy Manual (Pub. 100-02), Ch. 16 § 50
Items and Services Furnished, Paid for or Authorized by
50 - Items and Services Furnished, Paid for or Authorized by
Governmental Entities - Federal, State, or Local Governments
(Rev. 1, 10-01-03)
A3-3153, HO-260.3, B3-2309
The law contains three separate exclusions applicable to items and services furnished,
paid for or authorized by governmental entities. In general, payment may not be made
for items and services:
•
Furnished by a provider (Governmental or non governmental) or other person at
public expense pursuant to an authorization issued by a Federal agency (§50.1);
•
Furnished by a provider of services or agency of the Federal government (§50.2);
and
•
Paid for directly or indirectly by a Federal, State, or local governmental entity
(§50.3).
The A/B MAC (A) or (B) applies each of these exclusions separately, i.e., benefits are
excluded where any one of the exclusions applies.