CMS Rulings Issued Prior to 1995
Centers for Medicare & Medicaid Services (CMS) Rulings are decisions of the Administrator that serve as precedent final opinions and orders and statements of policy and interpretation. They provide clarification and interpretation of complex or ambiguous provisions of the law or regulations relating to Medicare, Medicaid, Utilization and Quality Control Peer Review, private health insurance, and related matters.
CMS Rulings are binding on all CMS components, Medicare contractors, the Provider Reimbursement Review Board, the Medicare Geographic Classification Review Board, and Administrative Law Judges (ALJs) of the Social Security Administration (SSA) who hear Medicare appeals. These Rulings promote consistency in interpretation of policy and adjudication of disputes.
The CMS Rulings that were issued prior to 1995 can be found below. This list is searchable and sortable.
All CMS Rulings issued in 1995 or after 1995 can be found on another section of CMS.gov: https://www.cms.gov/Regulations-and-Guidance/Guidance/Rulings/CMS-Rulings.html.
|HCFA Ruling 82-1||Exclusion from Medicare Coverage of DMSO for Conditions Other Than Interstitial Cystitis|
|HCFA Ruling 82-2c||Constitutionality of Part B Fair Hearing Procedures|
|HCFA Ruling 82-3||Conditions for Medicare Coverage of Surgery to Relieve Obstructions to Vertebral Artery Blood Flow (Vertebral Artery Surgery)|
|HCFA Ruling 83-1||Provider Reimbursement Review Board Decision on the Lack of Jurisdiction|
|HCFA Ruling 83-2||Criteria for Defining Skilled Nursing Facility Under Section 1861(j)(1) of the Social Security Act|
|HCFA Ruling 83-3||Revised Criteria for Defining Skilled Nursing Facility When Determinging a Beneficiary's Spell of Illness Status|
|HCFA Ruling 84-1||Provider Reimbursement Review Board Jurisdiction Over Appeals From Estimations of and Modifications to Base Year Costs Under the Prospective Payment System|
|HCFA Ruling 85-1||Exclusion of Cytotoxic Leukocyte Testing from Medicare Coverage|
|HCFA Ruling 85-2||Criteria for Medicare Coverage of Inpatient Hospital Rehabilitation Services|
|HCFA Ruling 86-1||Use of Statistical Sampling to Project Overpayments to Providers and Suppliers|
|HCFA Ruling 86-2||Provider Reimbursement Review Board Jurisdiction Over Challenges to the Application or the Validity of the Medicare Regulation Governing Apportionment of Malpractice Insurance Costs|
|HCFA Ruling 87-1||Criteria for Medicare Coverage of Heart Transplants|
|HCFA Ruling 87-2||Provider Reimbursement Review Board Jurisdiction Over Challenges to the Application or the Validity of the Medicare Regulation Governing Apportionment of Malpractice Insurance Costs|
|HCFA Ruling 87-3||Validity of Provider Reimbursement Manual Section 2345 Relating to the Inclusion of Labor-Delivery Room Days in the Calculation of Inpatient Days|
|HCFA Ruling 87-4||Payments Under Medicare and Awards Under the Federal Tort Claims Act|
|HCFA Ruling 89-1||Notice of Controlling Adverse Decisions by the Supreme Court and the DC Circuit Court of Appeals|
|HCFA Ruling 89-2||Notice of Intent to Settle HMO and CMP Cost Reports for Periods Beginning on or After January 1 1986 Without Application of Absolute Cost Limits|
|HCFA Ruling 90-1||Criteria for Medicare Coverage of Seat Lifts|
|HCFA Ruling 91-1||Notice of Decision to Follow a Consent Order Providing for the Discounted Application of the 1986 Medicare Malpractice Rule and a Reversion to the Pre-1979|
|HCFA Ruling 92-1||Skilled Nursing Facility and Nursing Facility Provider Agreements|
|HCFA Ruling 93-1||Weight to be Given to a Treating Physician's Opinion in Determining Medicare Coverage of Inpatient Care in a Hospital or Skilled Nursing Facility|
|HCFA Ruling 94-1||Policy Regarding Medicare Payments in the Event a Primary Payer is Bankrupt or Insolvent|
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