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 C - Medical Assistance Programs |
Part 438 - Managed Care |
Subpart J - Conditions for Federal Financial Participation (FFP) |
§ 438.812 - Costs under risk and nonrisk contracts.
Latest version.
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§ 438.812 Costs under risk and nonrisk contracts.
(a) Under a risk contract, the total amount the State agency pays for carrying out the contract provisions is a medical assistance cost.
(b) Under a nonrisk contract -
(1) The amount the State agency pays for the furnishing of medical services to eligible beneficiaries is a medical assistance cost; and
(2) The amount the State agency pays for the contractor's performance of other functions is an administrative cost.