GroundRules
42 CFR 417.580: Basis and scope.
Where this section sits in the code
- Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER B—MEDICARE PROGRAM
- PART 417—HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS
- Subpart P—Medicare Payment: Risk Basis
(a) Basis. This subpart implements those portions of section 1876 (a), (e), and (g) of the Act that pertain to the amount CMS pays an organization for its Medicare enrollees who are enrolled on a risk basis.
(b) Scope. This subpart sets forth—
(1) Method of payment;
(2) Procedures for determining the HMO's or CMP's payment rate; and
(3) Procedures for determining the additional benefits (and their value) the HMO or CMP must provide to its Medicare enrollees.
Collected 2026-08-27T02:26:11Z. Source file · JSON