State Responsibilities

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medical Assistance Programs
  6. Managed Care
  7. State Responsibilities

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Section
438.50

State Plan requirements.

Section
438.52

Choice of MCOs, PIHPs, PAHPs, PCCMs, and PCCM entities.

Section
438.54

Managed care enrollment.

Section
438.56

Disenrollment: Requirements and limitations.

Section
438.58

Conflict of interest safeguards.

Section
438.60

Prohibition of additional payments for services covered under MCO, PIHP or PAHP contracts.

Section
438.62

Continued services to enrollees.

Section
438.66

State monitoring requirements.

Section
438.68

Network adequacy standards.

Section
438.70

Stakeholder engagement when LTSS is delivered through a managed care program.

Section
438.71

Beneficiary support system.

Section
438.74

State oversight of the minimum MLR requirement.