42 CFR 422.400 - State licensure requirement.
Except in the case of a PSO granted a waiver under subpart H of this part, each MA organization must -
(a) Be licensed under State law, or otherwise authorized to operate under State law, as a risk-bearing entity (as defined in § 422.2) eligible to offer health insurance or health benefits coverage in each State in which it offers one or more MA plans;
(b) If not commercially licensed, obtain certification from the State that the organization meets a level of financial solvency and such other standards as the State may require for it to operate as an MA organization; and
(c) Demonstrate to CMS that -
(2) If applicable, it has obtained the State certification required under paragraph (b) of this section.