Part 403 — Special Programs and Projects
Subpart B — Medicare Supplemental Policies
- § 403.200— Basis and scope.
- § 403.201— State regulation of insurance policies.
- § 403.205— Medicare supplemental policy.
- § 403.206— General standards for Medicare supplemental policies.
- § 403.210— NAIC model standards.
- § 403.215— Loss ratio standards.
- § 403.220— Supplemental Health Insurance Panel.
- § 403.222— State with an approved regulatory program.
- § 403.231— Emblem.
- § 403.232— Requirements and procedures for obtaining certification.
- § 403.235— Review and certification of policies.
- § 403.239— Submittal of material to retain certification.
- § 403.245— Loss of certification.
- § 403.248— Administrative review of CMS determinations.
- § 403.250— Loss ratio calculations: General provisions.
- § 403.251— Loss ratio date and time frame provisions.
- § 403.253— Calculation of benefits.
- § 403.254— Calculation of premiums.
- § 403.256— Loss ratio supporting data.
- § 403.258— Statement of actuarial opinion.
Subpart C — Recognition of State Reimbursement Control Systems
- § 403.300— Basis and purpose.
- § 403.302— Definitions.
- § 403.304— Minimum requirements for State systems—discretionary approval.
- § 403.306— Additional requirements for State systems—mandatory approval.
- § 403.308— State systems under demonstration projects—mandatory approval.
- § 403.310— Reduction in payments.
- § 403.312— Submittal of application.
- § 403.314— Evaluation of State systems.
- § 403.316— Reconsideration of certain denied applications.
- § 403.318— Approval of State systems.
- § 403.320— CMS review and monitoring of State systems.
- § 403.321— State systems for hospital outpatient services.
- § 403.322— Termination of agreements for Medicare recognition of State systems.
Subpart G — Religious Nonmedical Health Care Institutions—Benefits, Conditions of Participation, and Payment
- § 403.700— Basis and purpose.
- § 403.702— Definitions and terms.
- § 403.720— Conditions for coverage.
- § 403.724— Valid election requirements.
- § 403.730— Condition of participation: Patient rights.
- § 403.732— Condition of participation: Quality assessment and performance improvement.
- § 403.734— Condition of participation: Food services.
- § 403.736— Condition of participation: Discharge planning.
- § 403.738— Condition of participation: Administration.
- § 403.740— Condition of participation: Staffing.
- § 403.742— Condition of participation: Physical environment.
- § 403.744— Condition of participation: Life safety from fire.
- § 403.745— Condition of participation: Building safety.
- § 403.746— Condition of participation: Utilization review.
- § 403.748— Condition of participation: Emergency preparedness.
- § 403.750— Estimate of expenditures and adjustments.
- § 403.752— Payment provisions.
- § 403.754— Monitoring expenditure level.
- § 403.756— Sunset provision.
- § 403.764— Basis and purpose of religious nonmedical health care institutions providing home service.
- § 403.766— Requirements for coverage and payment of RNHCI home services.
- § 403.768— Excluded services.
- § 403.770— Payments for home services.
Subpart H — Medicare Prescription Drug Discount Card and Transitional Assistance Program
- § 403.800— Basis and scope.
- § 403.802— Definitions.
- § 403.804— General rules for solicitation, application and Medicare endorsement period.
- § 403.806— Sponsor requirements for eligibility for endorsement.
- § 403.808— Use of transitional assistance funds.
- § 403.810— Eligibility and reconsiderations.
- § 403.811— Enrollment and disenrollment and associated endorsed sponsor requirements.
- § 403.812— HIPAA privacy, security, administrative data standards, and national identifiers.
- § 403.813— Marketing limitations and record retention requirements.
- § 403.814— Special rules concerning Part C organizations and Medicare cost plans and their enrollees.
- § 403.815— Special rules concerning States.
- § 403.816— Special rules concerning long-term care and I/T/U pharmacies.
- § 403.817— Special rules concerning the territories.
- § 403.820— Sanctions, penalties, and termination.
- § 403.822— Reimbursement of transitional assistance and associated sponsor requirements.
Subpart I — Transparency Reports and Reporting of Physician Ownership or Investment Interests
- § 403.900— Purpose and scope.
- § 403.902— Definitions.
- § 403.904— Reports of payments or other transfers of value to covered recipients.
- § 403.906— Reports of physician ownership and investment interests.
- § 403.908— Procedures for electronic submission of reports.
- § 403.910— Delayed publication for payments made under product research or development agreements and clinical investigations.
- § 403.912— Penalties for failure to report.
- § 403.914— Preemption of State laws.