42 C.F.R. § 438.600 Statutory basis.
Title 42 - Public Health
This subpart is based on sections 1902(a)(4), 1902(a)(19), 1903(m), and 1932(d)(1) of the Act. (a) Section 1902(a)(4) requires that the State plan provide for methods of administration that the Secretary finds necessary for the proper and efficient operation of the plan. (b) Section 1902(a)(19) requires that the State plan provide the safeguards necessary to ensure that eligibility is determined and services are provided in a manner consistent with simplicity of administration and the best interests of the recipients. (c) Section 1903(m) establishes conditions for payments to the State with respect to contracts with MCOs. (d) Section 1932(d)(1) prohibits MCOs and PCCMs from knowingly having certain types of relationships with individuals excluded under Federal regulations from participating in specified activities, or with affiliates of those individuals.
Title 42: Public Health
PART 438—MANAGED CARE
Subpart H—Certifications and Program Integrity
§ 438.600 Statutory basis.
