§ 422.1 - Basis and scope.  


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  • § 422.1 Basis and scope.

    (a) Basis. This part is based on the indicated provisions of the following:

    (1) The following provisions of the Act:

    (i) 1106 - Disclosure of information in possession of agency.

    (ii) 1128J(d) - Reporting and Returning of Overpayments.

    (iii) 1851 - Eligibility, election, and enrollment.

    (iv) 1852 - Benefits and beneficiary protections.

    (v) 1853 - Payments to Medicare Advantage (MA) organizations.

    (vi) 1854 - Premiums.

    (vii) 1855 - Organization, licensure, and solvency of MA organizations.

    (viii) 1856 - Standards.

    (ix) 1857 - Contract requirements.

    (x) 1858 - Special rules for MA Regional Plans.

    (xi) 1859 - Definitions; enrollment restriction for certain MA plans.

    (2) 8 U.S.C. 1611 - Aliens who are not qualified aliens ineligible for Federal public benefits.

    (b) Scope. This part establishes standards and sets forth the requirements, limitations, and procedures for Medicare services furnished, or paid for, by Medicare Advantage organizations through Medicare Advantage plans.

    [63 FR 35068, June 26, 1998, as amended at 70 FR 4714, Jan. 28, 2005; 80 FR 7958, Feb. 12, 2015; 81 FR 80556, Nov. 15, 2016]