42 CFR 447.46 - Timely claims payment by MCOs.

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§ 447.46 Timely claims payment by MCOs.

(a)Basis and scope. This section implements section 1932(f) of the Act by specifying the rules and exceptions for prompt payment of claims by MCOs.

(b)Definitions. “Claim” and “clean claim” have the meaning given those terms in § 447.45.

(c)Contract requirements -

(1)Basic rule. A contract with an MCO must provide that the organization will meet the requirements of § 447.45(d)(2) and (d)(3), and abide by the specifications of § 447.45(d)(5) and (d)(6).

(2)Exception. The MCO and its providers may, by mutual agreement, establish an alternative payment schedule.

(3)Alternative schedule. Any alternative schedule must be stipulated in the contract.

[ 67 FR 41115, June 14, 2002]

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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 447 after this date.

  • 2017-04-03; vol. 82 # 62 - Monday, April 3, 2017
    1. 82 FR 16114 - Medicaid Program; Disproportionate Share Hospital Payments—Treatment of Third Party Payers in Calculating Uncompensated Care Costs
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Final rule.
      These regulations are effective on June 2, 2017.
      42 CFR Part 447