{"data":{"id":"us/42-cfr-405.455","jurisdiction":"us","citation":"42 CFR 405.455","heading":"Application to Medicare Advantage contracts.","body":"An organization that has a contract with CMS to provide one or more Medicare Advantage (M + C) plans to beneficiaries (part 422 of this chapter):\n(a) Must acquire and maintain information from Medicare carriers on physicians and practitioners who have opted-out of Medicare.\n(b) Must make no payment directly or indirectly for Medicare covered services furnished to a Medicare beneficiary by a physician or practitioner who has opted-out of Medicare.\n(c) May make payment to a physician or practitioner who furnishes emergency or urgent care services to a beneficiary who has not previously entered into a private contract with the physician or practitioner in accordance with § 405.440.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED","Subpart D—Private Contracts"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"2182e858b4f9d3a08e600132e5cdd4208bcb9298566dbf21e11cb389898d0d37","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-405.450","next":"us/42-cfr-405.500"},"notice":"GroundRules: Original legal text. Not legal advice."}