Text
Title 42: Public Health
CHAPTER IV: CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)
SUBCHAPTER C: MEDICAL ASSISTANCE PROGRAMS
PART 447: PAYMENTS FOR SERVICES
Subpart F: Payment Methods for Other Institutional and Noninstitutional Services
: Prepaid Capitation Plans
447.362 - Upper limits of payment: Nonrisk contract.
Under a nonrisk contract, Medicaid payments to the contractor may not exceed?
(a) What Medicaid would have paid, on a fee-for-service basis, for the services actually furnished to recipients: plus
(b) The net savings of administrative costs the Medicaid agency achieves by contracting with the plan instead of purchasing the services on a fee-for-service basis.
[48 FR 54025, Nov. 30, 1983]
Sponsored links
