42 CFR 422.1 - Basis and scope.

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§ 422.1 Basis and scope.

(a)Basis. This part is based on the indicated provisions of the following:

(1) The following provisions of the Act:

(i) 1106 - Disclosure of information in possession of agency.

(ii) 1128J(d) - Reporting and Returning of Overpayments.

(iii) 1851 - Eligibility, election, and enrollment.

(iv) 1852 - Benefits and beneficiary protections.

(v) 1853 - Payments to Medicare Advantage (MA) organizations.

(vi) 1854 - Premiums.

(vii) 1855 - Organization, licensure, and solvency of MA organizations.

(viii) 1856 - Standards.

(ix) 1857 - Contract requirements.

(x) 1858 - Special rules for MA Regional Plans.

(xi) 1859 - Definitions; enrollment restriction for certain MA plans.

(2) 8 U.S.C. 1611 - Aliens who are not qualified aliens ineligible for Federal public benefits.

(b)Scope. This part establishes standards and sets forth the requirements, limitations, and procedures for Medicare services furnished, or paid for, by Medicare Advantage organizations through Medicare Advantage plans.

[ 63 FR 35068, June 26, 1998, as amended at 70 FR 4714, Jan. 28, 2005; 80 FR 7958, Feb. 12, 2015; 81 FR 80556, Nov. 15, 2016]

This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.


United States Code

Title 42 published on 19-Apr-2017 03:51

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR Part 422 after this date.

  • 2017-03-22; vol. 82 # 54 - Wednesday, March 22, 2017
    1. 82 FR 14639 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements; Corrections
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Final rule; correction.
      This correcting document is effective March 21, 2017 and is applicable beginning January 1, 2017.
      42 CFR Parts 405, 410, 411, 414, 417, 422, 423, 424, 425, and 460