Code of Federal Regulations (Last Updated: November 8, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter B - Medicare Program |
Part 421 - Medicare Contracting |
Subpart A - Scope, Definitions, and General Provisions |
§ 421.1 - Basis, applicability, and scope. |
§ 421.3 - Definitions. |
§ 421.5 - General provisions. |
Subpart B - Intermediaries |
§ 421.100 - Intermediary functions. |
§ 421.103 - Payment to providers. |
§ 421.104 - Assignment of providers of services to intermediaries during transition to Medicare Administrative Contractors (MACs). |
§ 421.105 - Notification of action on nomination. |
§ 421.106 - Change to another intermediary or to direct payment. |
§ 421.110 - Requirements for approval of an agreement. |
§ 421.112 - Considerations relating to the effective and efficient administration of the program. |
§ 421.114 - Assignment and reassignment of providers by CMS. |
§ 421.116 - Designation of national or regional intermediaries. |
§ 421.117 - Designation of regional and alternative designated regional intermediaries for home health agencies and hospices. |
§ 421.118 - Awarding of experimental contracts. |
§ 421.120 - Performance criteria. |
§ 421.122 - Performance standards. |
§ 421.124 - Intermediary's failure to perform efficiently and effectively. |
§ 421.126 - Termination of agreements. |
§ 421.128 - Intermediary's opportunity for hearing and right to judicial review. |
Subpart C - Carriers |
§ 421.200 - Carrier functions. |
§ 421.201 - Performance criteria and standards. |
§ 421.202 - Requirements and conditions. |
§ 421.203 - Carrier's failure to perform efficiently and effectively. |
§ 421.205 - Termination by the Secretary. |
§ 421.210 - Designations of regional carriers to process claims for durable medical equipment, prosthetics, orthotics and supplies. |
§ 421.212 - Railroad Retirement Board contracts. |
§ 421.214 - Advance payments to suppliers furnishing items or services under Part B. |
Subpart D - Medicare Integrity Program Contractors |
§ 421.300 - Basis, applicability, and scope. |
§ 421.302 - Eligibility requirements for Medicare integrity program contractors. |
§ 421.304 - Medicare integrity program contractor functions. |
§ 421.306 - Awarding of a contract. |
§ 421.308 - Renewal of a contract. |
§ 421.310 - Conflict of interest requirements. |
§ 421.312 - Conflict of interest resolution. |
§ 421.316 - Limitation on Medicare integrity program contractor liability. |
Subpart E - Medicare Administrative Contractors (MACs) |
§ 421.400 - Statutory basis and scope. |
§ 421.401 - Definitions. |
§ 421.404 - Assignment of providers and suppliers to MACs. |
Subpart F - XXX |
§ 421.500 - Medicare review function. |
§ 421.501 - Definitions. |
§ 421.505 - Termination and extension of non-random prepayment complex medical review. |