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FEDERAL · 42 CFR

Part 403 — Special Programs and Projects

87 sections · Title 42: Public Health

§ 403.200Basis and scope.
§ 403.201State regulation of insurance policies.
§ 403.205Medicare supplemental policy.
§ 403.206General standards for Medicare supplemental policies.
§ 403.210NAIC model standards.
§ 403.215Loss ratio standards.
§ 403.220Supplemental Health Insurance Panel.
§ 403.222State with an approved regulatory program.
§ 403.231Emblem.
§ 403.232Requirements and procedures for obtaining certification.
§ 403.235Review and certification of policies.
§ 403.239Submittal of material to retain certification.
§ 403.245Loss of certification.
§ 403.248Administrative review of CMS determinations.
§ 403.250Loss ratio calculations: General provisions.
§ 403.251Loss ratio date and time frame provisions.
§ 403.253Calculation of benefits.
§ 403.254Calculation of premiums.
§ 403.256Loss ratio supporting data.
§ 403.258Statement of actuarial opinion.
§ 403.300Basis and purpose.
§ 403.302Definitions.
§ 403.304Minimum requirements for State systems—discretionary approval.
§ 403.306Additional requirements for State systems—mandatory approval.
§ 403.308State systems under demonstration projects—mandatory approval.
§ 403.310Reduction in payments.
§ 403.312Submittal of application.
§ 403.314Evaluation of State systems.
§ 403.316Reconsideration of certain denied applications.
§ 403.318Approval of State systems.
§ 403.320CMS review and monitoring of State systems.
§ 403.321State systems for hospital outpatient services.
§ 403.322Termination of agreements for Medicare recognition of State systems.
§ 403.700Basis and purpose.
§ 403.702Definitions and terms.
§ 403.720Conditions for coverage.
§ 403.724Valid election requirements.
§ 403.730Condition of participation: Patient rights.
§ 403.732Condition of participation: Quality assessment and performance improvement.
§ 403.734Condition of participation: Food services.
§ 403.736Condition of participation: Discharge planning.
§ 403.738Condition of participation: Administration.
§ 403.740Condition of participation: Staffing.
§ 403.742Condition of participation: Physical environment.
§ 403.744Condition of participation: Life safety from fire.
§ 403.745Condition of participation: Building safety.
§ 403.746Condition of participation: Utilization review.
§ 403.748Condition of participation: Emergency preparedness.
§ 403.750Estimate of expenditures and adjustments.
§ 403.752Payment provisions.
§ 403.754Monitoring expenditure level.
§ 403.756Sunset provision.
§ 403.764Basis and purpose of religious nonmedical health care institutions providing home service.
§ 403.766Requirements for coverage and payment of RNHCI home services.
§ 403.768Excluded services.
§ 403.770Payments for home services.
§ 403.800Basis and scope.
§ 403.802Definitions.
§ 403.804General rules for solicitation, application and Medicare endorsement period.
§ 403.806Sponsor requirements for eligibility for endorsement.
§ 403.808Use of transitional assistance funds.
§ 403.810Eligibility and reconsiderations.
§ 403.811Enrollment and disenrollment and associated endorsed sponsor requirements.
§ 403.812HIPAA privacy, security, administrative data standards, and national identifiers.
§ 403.813Marketing limitations and record retention requirements.
§ 403.814Special rules concerning Part C organizations and Medicare cost plans and their enrollees.
§ 403.815Special rules concerning States.
§ 403.816Special rules concerning long-term care and I/T/U pharmacies.
§ 403.817Special rules concerning the territories.
§ 403.820Sanctions, penalties, and termination.
§ 403.822Reimbursement of transitional assistance and associated sponsor requirements.
§ 403.900Purpose and scope.
§ 403.902Definitions.
§ 403.904Reports of payments or other transfers of value to covered recipients.
§ 403.906Reports of physician ownership and investment interests.
§ 403.908Procedures for electronic submission of reports.
§ 403.910Delayed publication for payments made under product research or development agreements and clinical investigations.
§ 403.912Penalties for failure to report.
§ 403.914Preemption of State laws.
§ 403.1100Purpose and scope.
§ 403.1105Definitions.
§ 403.1110Evaluation of models.
§ 403.1200Scope.
§ 403.1201Definitions.
§ 403.1202Pricing information.
§ 403.1203Specific presentation requirements.
§ 403.1204Compliance.