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Medicare Act: Federal legislation governing Medicare program requirements and coverage determinations for healthcare services

Social Security Act: Federal law establishing social insurance programs and healthcare coverage guidelines

ACA: Patient Protection and Affordable Care Act establishing healthcare coverage requirements and patient protections

HIPAA: Health Insurance Portability and Accountability Act governing patient privacy and health information security

Federal Anti-Kickback Statute: Law prohibiting the exchange of anything of value to induce referrals of federal healthcare program business

Stark Law: Physician self-referral law restricting healthcare providers from referring patients to entities with which they have financial relationships

State Medical Practice Acts: State-specific laws governing medical practice, licensing, and standard of care requirements

State Healthcare Consent Laws: State-specific regulations for obtaining and documenting patient consent for medical services

State Consumer Protection Laws: State regulations protecting consumers from unfair practices, including healthcare billing and disclosure requirements

State Insurance Regulations: State-specific rules governing insurance coverage, billing practices, and patient financial responsibility

CMS Guidelines: Centers for Medicare & Medicaid Services administrative requirements for healthcare service delivery and billing

Medicare Benefit Policy Manual: Official guidance document detailing Medicare coverage policies and benefit requirements

Informed Consent Requirements: Legal obligations for obtaining patient understanding and agreement for non-covered services

Pricing Transparency Rules: Regulations requiring clear disclosure of service costs and patient financial obligations

Documentation Requirements: Specific record-keeping and documentation standards for non-covered services and patient acknowledgments