StacksVerified U.S. regulatory reference

42 CFR §422.400

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
Except in the case of a PSO granted a waiver under subpart H of this part, each MA organization must—
  1. (a)Be licensed under State law, or otherwise authorized to operate under State law, as a risk-bearing entity (as defined in § 422.2) eligible to offer health insurance or health benefits coverage in each State in which it offers one or more MA plans;
  2. (b)If not commercially licensed, obtain certification from the State that the organization meets a level of financial solvency and such other standards as the State may require for it to operate as an MA organization; and
  3. (c)Demonstrate to CMS that—
    1. (1)The scope of its license or authority allows the organization to offer the type of MA plan or plans that it intends to offer in the State; and
    2. (2)If applicable, it has obtained the State certification required under paragraph (b) of this section.