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Medicare Payment: Risk Basis

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medicare Program
  6. Health Maintenance Organizations, Competitive Medical Plans, and Health Care Prepayment Plans
  7. Medicare Payment: Risk Basis

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Section
417.580

Basis and scope.

Section
417.582

Definitions.

Section
417.584

Payment to HMOs or CMPs with risk contracts.

Section
417.585

Special rules: Hospice care.

Section
417.588

Computation of adjusted average per capita cost (AAPCC).

Section
417.590

Computation of the average of the per capita rates of payment.

Section
417.592

Additional benefits requirement.

Section
417.594

Computation of adjusted community rate (ACR).

Section
417.596

Establishment of a benefit stabilization fund.

Section
417.597

Withdrawal from a benefit stabilization fund.

Section
417.598

Annual enrollment reconciliation.

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