42 CFR Part 403
PART 403—SPECIAL PROGRAMS AND PROJECTS
- PART 403—SPECIAL PROGRAMS AND PROJECTS
- Chapter IV—Centers for Medicare & Medicaid Services, Department of Health and Human Services › Subchapter A—General Provisions
- Subpart A [Reserved]
- Subpart B—Medicare Supplemental Policies
- § 403.200 Basis and scope.
- General Provisions
- § 403.201 State regulation of insurance policies.
- § 403.205 Medicare supplemental policy.
- § 403.206 General standards for Medicare supplemental policies.
- § 403.210 NAIC model standards.
- § 403.215 Loss ratio standards.
- State Regulatory Programs
- § 403.220 Supplemental Health Insurance Panel.
- § 403.222 State with an approved regulatory program.
- Voluntary Certification Program: General Provisions
- § 403.231 Emblem.
- § 403.232 Requirements and procedures for obtaining certification.
- § 403.235 Review and certification of policies.
- § 403.239 Submittal of material to retain certification.
- § 403.245 Loss of certification.
- § 403.248 Administrative review of CMS determinations.
- Voluntary Certification Program: Loss Ratio Provisions
- § 403.250 Loss ratio calculations: General provisions.
- § 403.251 Loss ratio date and time frame provisions.
- § 403.253 Calculation of benefits.
- § 403.254 Calculation of premiums.
- § 403.256 Loss ratio supporting data.
- § 403.258 Statement of actuarial opinion.
- Subpart C—Recognition of State Reimbursement Control Systems
- § 403.300 Basis and purpose.
- § 403.302 Definitions.
- § 403.304 Minimum requirements for State systems—discretionary approval.
- § 403.306 Additional requirements for State systems—mandatory approval.
- § 403.308 State systems under demonstration projects—mandatory approval.
- § 403.310 Reduction in payments.
- § 403.312 Submittal of application.
- § 403.314 Evaluation of State systems.
- § 403.316 Reconsideration of certain denied applications.
- § 403.318 Approval of State systems.
- § 403.320 CMS review and monitoring of State systems.
- § 403.321 State systems for hospital outpatient services.
- § 403.322 Termination of agreements for Medicare recognition of State systems.
- Subparts D—F [Reserved]
- Subpart G—Religious Nonmedical Health Care Institutions—Benefits, Conditions of Participation, and Payment
- § 403.700 Basis and purpose.
- § 403.702 Definitions and terms.
- § 403.720 Conditions for coverage.
- § 403.724 Valid election requirements.
- § 403.730 Condition of participation: Patient rights.
- § 403.732 Condition of participation: Quality assessment and performance improvement.
- § 403.734 Condition of participation: Food services.
- § 403.736 Condition of participation: Discharge planning.
- § 403.738 Condition of participation: Administration.
- § 403.740 Condition of participation: Staffing.
- § 403.742 Condition of participation: Physical environment.
- § 403.744 Condition of participation: Life safety from fire.
- § 403.745 Condition of participation: Building safety.
- § 403.746 Condition of participation: Utilization review.
- § 403.748 Condition of participation: Emergency preparedness.
- § 403.750 Estimate of expenditures and adjustments.
- § 403.752 Payment provisions.
- § 403.754 Monitoring expenditure level.
- § 403.756 Sunset provision.
- § 403.764 Basis and purpose of religious nonmedical health care institutions providing home service.
- § 403.766 Requirements for coverage and payment of RNHCI home services.
- § 403.768 Excluded services.
- § 403.770 Payments for home services.
- Subpart H—Medicare Prescription Drug Discount Card and Transitional Assistance Program
- § 403.800 Basis and scope.
- § 403.802 Definitions.
- § 403.804 General rules for solicitation, application and Medicare endorsement period.
- § 403.806 Sponsor requirements for eligibility for endorsement.
- § 403.808 Use of transitional assistance funds.
- § 403.810 Eligibility and reconsiderations.
- § 403.811 Enrollment and disenrollment and associated endorsed sponsor requirements.
- § 403.812 HIPAA privacy, security, administrative data standards, and national identifiers.
- § 403.813 Marketing limitations and record retention requirements.
- § 403.814 Special rules concerning Part C organizations and Medicare cost plans and their enrollees.
- § 403.815 Special rules concerning States.
- § 403.816 Special rules concerning long-term care and I/T/U pharmacies.
- § 403.817 Special rules concerning the territories.
- § 403.820 Sanctions, penalties, and termination.
- § 403.822 Reimbursement of transitional assistance and associated sponsor requirements.
- Subpart I—Transparency Reports and Reporting of Physician Ownership or Investment Interests
- § 403.900 Purpose and scope.
- § 403.902 Definitions.
- § 403.904 Reports of payments or other transfers of value to covered recipients.
- § 403.906 Reports of physician ownership and investment interests.
- § 403.908 Procedures for electronic submission of reports.
- § 403.910 Delayed publication for payments made under product research or development agreements and clinical investigations.
- § 403.912 Penalties for failure to report.
- § 403.914 Preemption of State laws.
- Subpart K—Access to Identifiable Data for the Center for Medicare and Medicaid Models
- § 403.1100 Purpose and scope.
- § 403.1105 Definitions.
- § 403.1110 Evaluation of models.
- Subpart L—Requirements for Direct-to-Consumer Television Advertisements of Drugs and Biological Products To Include the List Price of That Advertised Product
- § 403.1200 Scope.
- § 403.1201 Definitions.
- § 403.1202 Pricing information.
- § 403.1203 Specific presentation requirements.
- § 403.1204 Compliance.
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