# Medicare and Medicaid Programs; Religious Nonmedical Health Care Institutions and Advance Directives
> **Centers for Medicare and Medicaid Services** · Final rule. · Published 2003-11-28 · Effective 2003-12-29 · 68 FR 66710
## Document
- **Document number:** 03-29139
- **Category:** medicare
- **Sub-agency:** Centers for Medicare and Medicaid Services
- **Federal Register citation:** 68 FR 66710
- **CFR reference:** 42 CFR 403
- **Publication date:** 2003-11-28
- **Effective date:** 2003-12-29
- **HHS docket:** CMS-1909-F
## 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.

## Source
- [Federal Register document](https://www.federalregister.gov/documents/2003/11/28/03-29139/medicare-and-medicaid-programs-religious-nonmedical-health-care-institutions-and-advance-directives)
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