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 2015-11-28

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR Part 447 after this date.

  • 2016-11-15; vol. 81 # 220 - Tuesday, November 15, 2016
    1. 81 FR 80003 - Medicaid Program; Covered Outpatient Drug; Delay in Change in Definitions of States and United States
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Interim final rule with comment period.
      Effective date: These regulations are effective on November 15, 2016. Comment date: To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on January 17, 2017.
      42 CFR Part 447