§ 422.300 - Basis and scope.

§ 422.300 Basis and scope.

Cross Reference

Link to an amendment published at 88 FR 6665, Feb. 1, 2023.

This subpart is based on sections 1106, 1128J(d), 1852, 1853, 1854, and 1858 of the Act. It sets forth the rules requirements for making payments to Medicare Advantage ( MA ) organizations offering local and regional MA planspolicies, 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, collection of improper payments and other payment rules. See § Section 422.458 in subpart J for rules on specifies the requirements for risk sharing payments to MA regional organizations.

[79 88 FR 503586665, AugFeb. 221, 20142023]