Code of Federal Regulations (Last Updated: July 5, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter D - State Children'S Health Insurance Programs (Schips) |
Part 457 - Allotments and Grants to States |
Subpart I - Program Integrity |
§ 457.902 - Definitions
Latest version.
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Link to an amendment published at 81 FR 27897, May 6, 2016.
As used in this subpart—
Actuarially sound principles means generally accepted actuarial principles and practices that are applied to determine aggregate utilization patterns, are appropriate for the population and services to be covered, and have been certified by actuaries who meet the qualification standards established by the Actuarial Standards Board.
Fee-for-service entity means any individual or entity that furnishes services under the program on a fee-for-service basis, including health insurance services.