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Federal regulations · Through 2026-08-25 · Newer source version available

42 CFR 417.412: Qualifying condition: Administration and management.

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Where this section sits in the code
  1. Title 42—Public Health
  2. CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
  3. SUBCHAPTER B—MEDICARE PROGRAM
  4. PART 417—HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS
  5. Subpart J—Qualifying Conditions for Medicare Contracts

The HMO or CMP must demonstrate that it—

(a) Has sufficient administrative capability to carry out the requirements of the contract; and

(b) Does not have any agents or management staff or persons with ownership or control interests who have been convicted of criminal offenses related to their involvement in Medicaid, Medicare, or social service programs under title XX of the Act.

Collected 2026-08-27T02:26:11Z. Source file · JSON

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