42 CFR § 447.362
Upper limits of payment: Nonrisk contract
June 11, 2020
Under a nonrisk contract, Medicaid payments to the contractor may not exceed—
(a) What Medicaid would have paid, on a fee-for-service basis, for the services actually furnished to beneficiaries: plus
(b) The net savings of administrative costs the Medicaid agency achieves by contracting with the plan instead of purchasing the services on a fee-for-service basis.
[48 FR 54025, Nov. 30, 1983]