Title 42

PART 422 SUBPART G

Subpart G - Payments to Medicare Advantage Organizations Source:70 FR 4729, Jan. 28, 2005, unless otherwise noted.

• 42 U.S.C. 1302 and 1395hh.
• Source: 63 FR 18134, Apr. 14, 1998, unless otherwise noted.

42:3.0.1.1.9.7.10.1	SECTION 422.300	422.300 Basis and scope.
42:3.0.1.1.9.7.10.2	SECTION 422.304	422.304 Monthly payments.
42:3.0.1.1.9.7.10.3	SECTION 422.306	422.306 Annual MA capitation rates.
42:3.0.1.1.9.7.10.4	SECTION 422.308	422.308 Adjustments to capitation rates, benchmarks, bids, and payments.
42:3.0.1.1.9.7.10.5	SECTION 422.310	422.310 Risk adjustment data.
42:3.0.1.1.9.7.10.6	SECTION 422.311	422.311 RADV audit dispute and appeal processes.
42:3.0.1.1.9.7.10.7	SECTION 422.312	422.312 Announcement of annual capitation rate, benchmarks, and methodology changes.
42:3.0.1.1.9.7.10.8	SECTION 422.314	422.314 Special rules for beneficiaries enrolled in MA MSA plans.
42:3.0.1.1.9.7.10.9	SECTION 422.316	422.316 Special rules for payments to Federally qualified health centers.
42:3.0.1.1.9.7.10.10	SECTION 422.318	422.318 Special rules for coverage that begins or ends during an inpatient hospital stay.
42:3.0.1.1.9.7.10.11	SECTION 422.320	422.320 Special rules for hospice care.
42:3.0.1.1.9.7.10.12	SECTION 422.322	422.322 Source of payment and effect of MA plan election on payment.
42:3.0.1.1.9.7.10.13	SECTION 422.324	422.324 Payments to MA organizations for graduate medical education costs.
42:3.0.1.1.9.7.10.14	SECTION 422.326	422.326 Reporting and returning of overpayments.
42:3.0.1.1.9.7.10.15	SECTION 422.330	422.330 CMS-identified overpayments associated with payment data submitted by MA organizations.

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