1999 CFR Title 42, Volume 3

Title 42--Public Health CHAPTER IV--HEALTH CARE FINANCING ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 434--CONTRACTS
	434.1	Basis and scope.
	434.2	Definitions.
	434.4	State plan requirement.
	434.6	General requirements for all contracts and subcontracts.
	434.10	Contracts with fiscal agents.
	434.12	Contracts with private nonmedical institutions.
	434.20	Basic rules.
	434.21	Contracts that must meet additional requirements.
	434.22	Application of sanctions to risk comprehensive contracts.
	434.23	Capitation fees.
	434.25	Coverage and enrollment.
	434.26	Composition of enrollment.
	434.27	Termination of enrollment.
	434.28	Advance directives.
	434.29	Choice of health professional.
	434.30	Emergency medical service.
	434.32	Grievance procedure.
	434.34	Quality assurance system.
	434.36	Marketing.
	434.38	Inspection and audit of HMO's financial records.
	434.40	Contract requirements.
	434.42	Application of sanctions to risk comprehensive contracts.
	434.44	Special rules for certain health insuring organizations.
	434.50	Proof of HMO or PHP capability.
	434.52	Furnishing of required services.
	434.53	Periodic medical audits.
	434.57	Limit on payment to other providers.
	434.59	Continued service to recipients whose enrollment is terminated.
	434.61	Computation of capitation fees.
	434.63	Monitoring procedures.
	434.65	Services included in the State plan but not covered by the contract.
	434.67	Sanctions against HMOs with risk comprehensive contracts.
	434.70	Condition for FFP.
	434.71	Condition for FFP: Prior approval.
	434.72	Effect of a final determination that a provisional status HMO is not an HMO.
	434.74	Costs under risk-basis contracts.
	434.75	Costs under no-risk contracts.
	434.76	Costs under fiscal agent contracts.
	434.78	Right to reconsideration of disallowance.
	434.80	Condition for FFP in contracts with HMOs.