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Code of Federal Regulations (Last Updated: May 6, 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 A - Payments: General Provisions |
| § 447.1 - Purpose. |
| § 447.10 - Prohibition against reassignment of provider claims. |
| § 447.15 - Acceptance of State payment as payment in full. |
| § 447.20 - Provider restrictions: State plan requirements. |
| § 447.21 - Reduction of payments to providers. |
| § 447.25 - Direct payments to certain beneficiaries for physicians' or dentists' services. |
| § 447.26 - Prohibition on payment for provider-preventable conditions. |
| § 447.30 - Withholding the Federal share of payments to Medicaid providers to recover Medicare overpayments. |
| § 447.31 - Withholding Medicare payments to recover Medicaid overpayments. |
| § 447.40 - Payments for reserving beds in institutions. |
| § 447.45 - Timely claims payment. |
| § 447.46 - Timely claims payment by MCOs. |
| Alternative Premiums and Cost Sharing Under Section 1916A |
| § 447.62 - Alternative premiums and cost sharing: Basis, purpose and scope. |
| § 447.64 - Alternative premiums, enrollment fees, or similar fees: State plan requirements. |
| § 447.66 - General alternative premium protections. |
| § 447.68 - Alternative copayments, coinsurance, deductibles, or similar cost sharing charges: State plan requirements. |
| § 447.70 - General alternative cost sharing protections. |
| § 447.71 - Alternative premium and cost sharing exemptions and protections for individuals with family incomes at or below 100 percent of the FPL. |
| § 447.72 - Alternative premium and cost sharing exemptions and protections for individuals with family incomes above 100 percent but at or below 150 percent of the FPL. |
| § 447.74 - Alternative premium and cost sharing protections for individuals with family incomes above 150 percent of the FPL. |
| § 447.76 - Public schedule. |
| § 447.78 - Aggregate limits on alternative premiums and cost sharing. |
| § 447.80 - Enforceability of alternative premiums and cost sharing. |
| § 447.82 - Restrictions on payments to providers. |
| federal financial participation |
| § 447.59 - FFP: Conditions relating to cost sharing. |
| § 447.60 - Cost-sharing requirements for services furnished by MCOs. |
| Medicaid Premiums and Cost Sharing |
| § 447.50 - Premiums and cost sharing: Basis and purpose. |
| § 447.51 - Definitions. |
| § 447.52 - Cost sharing. |
| § 447.53 - Cost sharing for drugs. |
| § 447.54 - Cost sharing for services furnished in a hospital emergency department. |
| § 447.55 - Premiums. |
| § 447.56 - Limitations on premiums and cost sharing. |
| § 447.57 - Beneficiary and public notice requirements. |
| § 447.88 - Options for claiming FFP payment for section 1920A presumptive eligibility medical assistance payments. |
| § 447.90 - FFP: Conditions related to pending investigations of credible allegations of fraud against the Medicaid program. |
| Cost Sharing |
| deductible, coinsurance, co-payment or similar cost-sharing charge |
| § 447.58 - Payments to prepaid capitation organizations. |
| enrollment fee, premium or similar cost sharing charge |