42 C.F.R. § 438.604 Data that must be certified.
Title 42 - Public Health
(a) Data certifications. When State payments to an MCO or PIHP are based on data submitted by the MCO or PIHP, the State must require certification of the data as provided in §438.606. The data that must be certified include, but are not limited to, enrollment information, encounter data, and other information required by the State and contained in contracts, proposals, and related documents. (b) Additional certifications. Certification is required, as provided in §438.606, for all documents specified by the State.
Title 42: Public Health
PART 438—MANAGED CARE
Subpart H—Certifications and Program Integrity
§ 438.604 Data that must be certified.
