42 CFR 417.484 : 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) — Health Maintenance Organizations, Competitive Medical Plans, And Health Care Prepayment Plans (§ 417.1 To § 417.940) — Medicare Contract Requirements (§ 417.470 To § 417.500) — Requirement applicable to related entities.

4 Aug 2016

(a) Definition. As used in this section, related entity means any entity that is related to the HMO or CMP by common ownership or control and -

(1) Performs some of the HMO's or CMP's management functions under contract or delegation;

(2) Furnishes services to Medicare enrollees under an oral or written agreement; or

(3) Leases real property or sells materials to the HMO or CMP at a cost of more than $2,500 during a contract period.

(b) Requirement. The contract must provide that the HMO or CMP agrees to require all related entities to agree that -

(1) HHS, the Comptroller General, or their designees have the right to inspect, evaluate, and audit any pertinent books, documents, papers, and records of the subcontractor involving transactions related to the subcontract; and

(2) The right under paragraph (b)(1) of this section to information for any particular contract period will exist for a period equivalent to that specified in § 417.482(f).

42 CFR 417.484
[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993]