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by the patient in their home unless it was a reasonable and necessary part of the patient’s
treatment. See also §80.
A health care item or service for the purpose of causing, or assisting to cause, the death of
any individual (assisted suicide) is not covered. This prohibition does not apply to the
provision of an item or service for the purpose of alleviating pain or discomfort, even if
such use may increase the risk of death, so long as the item or service is not furnished for
the specific purpose of causing death.
30 - Foot Care
(Rev. 1, 10-01-03)
Some foot care is excluded and some is covered. A description of both is in Chapter 15,
§290.
40 - No Legal Obligation to Pay for or Provide Services
(Rev. 1, 10-01-03)
A3-3152, HO-260.2, B3-2306
Program payment may not be made for items or services which neither the beneficiary
nor any other person or organization has a legal obligation to pay for or provide. This
exclusion applies where items and services are furnished gratuitously without regard to
the beneficiary’s ability to pay and without expectation of payment from any source, such
as free x-rays or immunizations provided by health organizations. However, Medicare
reimbursement is not precluded merely because a provider, physician, or supplier waives
the charge in the case of a particular patient or group or class of patients, as the waiver of
charges for some patients does not impair the right to charge others, including Medicare
patients. The determinative factor in applying this exclusion is the reason the particular
individual is not charged.
The following sections illustrate the applicability of this exclusion to various situations
involving services other than those paid for directly or indirectly by a governmental
entity. (For a discussion of the latter, see §50.)
40.1 - Indigence
(Rev. 1, 10-01-03)
A3-3152.A, HO-260.2.A
This exclusion does not apply where items and services are furnished to an indigent
individual without charge because of their inability to pay, if the provider, physician, or
supplier bills other patients to the extent that they are able to pay.
40.2 - Provider, Physician, or Supplier Bills Only Insured Patients
(Rev. 1, 10-01-03)
A3-3152.B, HO-260.2.B