StacksVerified U.S. regulatory reference

42 CFR §417.533

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
In paying for Part B services furnished to its enrollees by suppliers, the HMO or CMP must—
  1. (a)Determine the eligibility of individuals to receive those services through the HMO or CMP;
  2. (b)Make proper coverage decisions and appropriate payment as authorized under § 421.200 of this chapter for the services for which its Medicare enrollees are eligible; and
  3. (c)Carry out any other procedures that CMS may require.