42 C.F.R. § 457.515 Co-payments, coinsurance, deductibles, or similar cost-sharing charges: State plan requirements.
Title 42 - Public Health
To impose copayments, coinsurance, deductibles or similar charges on enrollees, the State plan must describe— (a) The service for which the charge is imposed; (b) The amount of the charge; (c) The group or groups of enrollees that may be subject to the cost-sharing charge; (d) The consequences for an enrollee who does not pay a charge, and the disenrollment protections adopted by the State in accordance with §457.570; (e) The methodology used to ensure that total cost-sharing liability for a family does not exceed the cumulative cost-sharing maximum specified in §457.560; and (f) An assurance that enrollees will not be held liable for cost-sharing amounts for emergency services that are provided at a facility that does not participate in the enrollee's managed care network beyond the copayment amounts specified in the State plan for emergency services as defined in §457.10.
Title 42: Public Health
PART 457—ALLOTMENTS AND GRANTS TO STATES
Subpart E—State Plan Requirements: Enrollee Financial Responsibilities
§ 457.515 Co-payments, coinsurance, deductibles, or similar cost-sharing charges: State plan requirements.
