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Code of Federal Regulations (Last Updated: July 5, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter C - Medical Assistance Programs |
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Part 447 - Payments for Services |
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Subpart F - Payment Methods for Other Institutional and Noninstitutional Services |
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Prepaid Capitation Plans |
§ 447.361 - Upper limits of payment: Risk contract.
Latest version.
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Link to an amendment published at 66 FR 6426, Jan. 19, 2001. This amendment was delayed until June 18, 2001, at 66 FR 11546, Feb. 26, 2001. This amendment was delayed until Aug. 17, 2001 at 66 FR 32776, June 18, 2001. This amendment was delayed until Aug. 16, 2002 at 66 FR 43090, Aug. 17, 2001. Under a risk contract, Medicaid payments to the contractor, for a defined scope of services to be furnished to a defined number of recipients, may not exceed the cost to the agency of providing those same services on a fee-for-service basis, to an actuarially equivalent nonenrolled population group.
Effective Date Note: At 66 FR 6426, Jan. 19, 2001, § 447.361 was removed, effective April 19, 2001. At 66 FR 11546, Feb. 26, 2001 the effective date was delayed until June 18, 2001, at 66 FR 32776, June 18, 2001 it was furthered delayed until Aug. 17, 2001, and at 66 FR 43090, Aug. 17, 2001 it was furthered delayed until Aug. 16, 2002.