{"abstract":"This final rule implements requirements under the Balanced Budget Act of 1997, which set forth requirements for the new Religious Nonmedical Health Care Institution program and advance directives. This rule finalizes the Medicare requirements for coverage and payment of services furnished by religious nonmedical health care institutions, the conditions of participation that these institutions must meet before they can participate in Medicare, and the methodology we will use to pay these institutions and monitor expenditures for services they furnish. This rule also finalizes the rules governing States' optional coverage of religious nonmedical health care institution services under the Medicaid program. Additionally, this final rule addresses comments we received on the November 30, 1999, interim final rule and also makes minor changes to clarify our policy. Lastly, this rule incorporates a minor change to the requirements for advance directives.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare and Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2003/11/28/03-29139.html","cfr_references":[{"chapter":null,"citation_url":null,"part":403,"title":42},{"chapter":null,"citation_url":null,"part":489,"title":42},{"chapter":null,"citation_url":null,"part":498,"title":42}],"citation":"68 FR 66710","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective date: These regulations are effective December 29, 2003.","disposition_notes":null,"docket_ids":["CMS-1909-F"],"dockets":[],"document_number":"03-29139","effective_on":"2003-12-29","end_page":66721,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2003/11/28/03-29139.xml","html_url":"https://www.federalregister.gov/documents/2003/11/28/03-29139/medicare-and-medicaid-programs-religious-nonmedical-health-care-institutions-and-advance-directives","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/03-29139?publication_date=2003-11-28","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2003-11-28/03-29139/mods.xml","not_received_for_publication":null,"page_length":12,"page_views":{"count":909,"last_updated":"2026-08-26 12:15:06 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2003-11-28/pdf/03-29139.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2003-11-28","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2003/11/28/03-29139.txt","regulation_id_number_info":{"0938-AI93":{"issue":"200310","html_url":"https://www.federalregister.gov/regulations/0938-AI93/coverage-of-religious-nonmedical-health-care-institutions-cms-1909-f-","title":"Coverage of Religious Nonmedical Health Care Institutions (CMS-1909-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=200310&RIN=0938-AI93&operation=OPERATION_EXPORT_XML","priority_category":"Substantive, Nonsignificant"}},"regulation_id_numbers":["0938-AI93"],"regulations_dot_gov_info":{},"regulations_dot_gov_url":null,"significant":false,"signing_date":null,"start_page":66710,"subtype":null,"title":"Medicare and Medicaid Programs; Religious Nonmedical Health Care Institutions and Advance Directives","toc_doc":"Religious nonmedical health care institutions and advance directives","toc_subject":"Medicare and Medicaid:","topics":["Administrative practice and procedure","Health facilities","Health insurance","Health professions","Hospitals","Intergovernmental relations","Medicare","Reporting and recordkeeping requirements"],"type":"Rule","volume":68}