Items and Services Furnished by Federal Provider of Services or

50.2 - Items and Services Furnished by Federal Provider of Services or Federal Agency (Rev. 1, 10-01-03) A3-3153.2, HO-260.3.A, B3-2309.1 Generally, Federal providers are excluded from participation in the Medicare program. However, Federal hospitals, like other nonparticipating hospitals, may be paid for emergency inpatient and outpatient hospital services. Additionally, payment is precluded for items and services rendered by a federally operated nonprovider, e.g., Veterans Administration clinics. A provider or other facility acquired by the Department of Housing and Urban Development (DHUD) in the administration of an FHA mortgage insurance program is not considered to be a Federal provider or agency and this exclusion is not applicable to services furnished by such facilities. The law provides exceptions to this exclusion which permits the following categories of Federal providers to participate in Medicare: • Hospitals and SNFs of Indian Health Service; and • A Federal provider which is determined to be providing services to the public generally as a community institution or agency. VA hospitals which have sharing agreements with non-VA participating hospitals under which the VA hospitals furnish end-stage renal disease (ESRD) services to nonveterans may be considered community hospitals with respect to any otherwise covered service rendered to ESRD beneficiaries. This exception does not apply to Federal clinics or other Federal health facilities which are not “providers of services” as defined in the Medicare law, i.e., which are not hospitals, SNFs, HHAs or CORFs. The CMS is responsible for processing claims for services furnished directly by Federal providers. If the A/B MAC (A) were to receive a request for Medicare reimbursement of such services it would forward the request to: Centers for Medicare & Medicaid Services Office of Financial Management P.O. Box 17255 Baltimore, Maryland 21203-7255 NOTE: The VA copayment provisions mentioned in §50.1.1 also applies to inpatient services furnished in a VA hospital. Should the A/B MAC (A) receive a request for Medicare reimbursement of VA copayment amounts for emergency services furnished by VA hospitals, it would refer the request to CMS.