Code of Federal Regulations (Last Updated: July 5, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter B - Medicare Program |
Part 422 - Medicare Advantage Program |
Subpart K - Application Procedures and Contracts for Medicare Advantage Organizations |
§ 422.527 - Agreements with Federally qualified health centers.
Latest version.
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§ 422.527 Agreements with Federally qualified health centers.
The contract between the MA organization and CMS must specify that -
(a) The MA organization must pay a Federally qualified health center (FQHC) a similar amount to what it pays other providers for similar services.
(b) Under such a contract, the FQHC must accept this payment as payment in full, except for allowable cost sharing which it may collect.
(c) Financial incentives, such as risk pool payments or bonuses, and financial withholdings are not considered in determining the payments made by CMS under § 422.316(a).
[70 FR 4738, Jan. 28, 2005]