allowable costs

allowable costs

charges for health care services and/or supplies for which insurance benefits are available. In general, costs of services not considered to be reasonable or necessary to the proper provision of health services are excluded from allowable costs. Allowable costs vary across insurance companies.
References in periodicals archive ?
The allowable costs of transport facilities in all areas to be covered were estimated at approximately eur 10 595 000 net.
Gatchalian's bill would also require the ERC to conduct an annual review of system-loss charges to ensure that only allowable costs within the caps stipulated are being recovered.
The bill also requires ERC to conduct an annual review of system loss charges to ensure that only allowable costs within the caps stipulated are being recovered.
The ERC shall also conduct an annual review of system loss charges to ensure that only allowable costs within the caps stipulated are being recovered.
For instance, from 2014-2016, when an insurer's QHPs' allowable costs in a calendar year exceed the aggregate premiums by a certain threshold, the insurer is entitled to receive payments from the HHS, as set forth in section 1342 of the ACA and its implementing regulations.
If a provider accepts Medicare, it must accept this rate; Medicare pays 80 percent of the allowable costs and you're responsible for the other 20 percent.
In the face of rising drug prices, many lawmakers have instituted policies that only worsen the situation, such as banning efficient pharmacy networks, restricting mail-order pharmacies and restricting maximum allowable costs, claims Herrick.
In return for the zoning waivers for affordable housing, the developer must limit profits to 20 percent of allowable costs.
In price-led costing, the price the customer is willing to pay determines allowable costs, beginning with design costs and ending with service costs.
1106 because the agency lacks data on maximum allowable costs for each MCO," the memo states.
ULA and Boeing believe that the 2006 and 2008 agreements with the government are appropriate recognition of legitimate, allowable costs, and that the United Launch Alliance's recovery of these costs is fully compliant with all cost accounting standards and government regulations," according to the statement.
The rates paid in January through June of each year are weighted to compensate or penalize nursing homes whose 2010 rates were either above or below their actual allowable costs under the state's Medicaid formula.