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42 CFR 422.300 : Public Health (Part 1 To Parts 1009-1099) — (§ 414.1 To Parts 427-429) — Centers For Medicare & Medicaid Services, Department Of Health And Human Services (Continued) (§ 414.1 To Parts 427-429) — Medicare Program (Continued) (§ 414.1 To Parts 427-429) — Medicare Advantage Program (§ 422.1 To § 422.2615) — Payments To Medicare Advantage Organizations (§ 422.300 To § 422.330) — Basis and scope.

4 Aug 2016

This subpart is based on sections 1106, 1128J(d), 1853, 1854, and 1858 of the Act. It sets forth the rules for making payments to Medicare Advantage (MA) organizations offering local and regional MA plans, including calculation of MA capitation rates and benchmarks, conditions under which payment is based on plan bids, adjustments to capitation rates (including risk adjustment), collection of risk adjustment data, conditions for use and disclosure of risk adjustment data, and other payment rules. See § 422.458 in subpart J for rules on risk sharing payments to MA regional organizations.

42 CFR 422.300
[79 FR 50358, Aug. 22, 2014]