42 C.F.R. § 447.362 Upper limits of payment: Nonrisk contract.
Title 42 - Public Health
Under a nonrisk contract, Medicaid payments to the contractor may not exceed— (a) What Medicaid would have paid, on a fee-for-service basis, for the services actually furnished to recipients: plus (b) The net savings of administrative costs the Medicaid agency achieves by contracting with the plan instead of purchasing the services on a fee-for-service basis. [48 FR 54025, Nov. 30, 1983]
Title 42: Public Health
PART 447—PAYMENTS FOR SERVICES
Subpart F—Payment Methods for Other Institutional and Noninstitutional Services
Prepaid Capitation Plans
§ 447.362 Upper limits of payment: Nonrisk contract.
