42 CFR §422.2490
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Terminology. Subject to the exclusions in paragraph (b) of this section, Part C MLR data consists of the information submitted under § 422.2460.
- (b)Exclusions from Part C MLR data. For the purpose of this section, the following items are excluded from Part C MLR data:
- (1)Narrative descriptions that MA organizations submit to support the information reported to CMS pursuant to the reporting requirements at § 422.2460, such as descriptions of expense allocation methods.
- (2)
- (i)Information that is reported at the plan level, such as the number of member months associated with each plan under a contract, including information submitted for a contract consisting of only one plan.
- (ii)Amounts that are reported as expenditures for a specific type of supplemental benefit, where the entire amount that is reported represents costs incurred by the only plan under the contract that offers that benefit.
- (3)Any information that could be used to identify Medicare beneficiaries or other individuals.
- (4)MLR review correspondence.
- (5)Any information for a contract for those contract years for which the contract is determined to be non-credible, as defined in accordance with § 422.2440(d).
- (c)Data release. CMS releases to the public Part C MLR data, for each contract for each contract year, no earlier than 18 months after the end of the applicable contract year.