GroundRules
42 CFR 423.322: Requirement for disclosure of information.
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 423—VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT
- Subpart G—Payments to Part D Plan Sponsors For Qualified Prescription Drug Coverage
(a) Payment conditional upon provision of information. Payments to a Part D sponsor are conditioned upon provision of information to CMS that is necessary to carry out this subpart, or as required by law.
(b) Restrictions on use of information. (1) Officers, employees, and contractors of the Department of Health and Human Services may use the information disclosed or obtained in accordance with the provisions of this subpart for the purposes of, and to the extent necessary—
(i) In carrying out this subpart, including, but not limited to, determination of payments, and payment-related oversight and program integrity activities.
(ii) In conducting oversight, evaluation, and enforcement under Title XVIII of the Act.
(2) The United States Attorney General and the Comptroller General of the United States may use the information disclosed or obtained in accordance with the provisions of this subpart for purposes of, and to the extent necessary in, carrying out health oversight activities.
(3) The restrictions described in paragraphs (b)(1) and (2) of this section do not limit either of the following:
(i) OIG's authority to fulfill the Inspector General's responsibilities in accordance with applicable Federal law.
(ii) CMS' ability to use data regarding drug claims in accordance with section 1848(m) of the Act.
Collected 2026-08-27T02:26:11Z. Source file · JSON