---
kind: "section"
citation: "42 C.F.R. § 405.455"
title: "42"
number: "405.455"
heading: "Application to Medicare Advantage contracts."
url: "https://uscodex.org/cfr/42/405.455"
---

# §405.455. Application to Medicare Advantage contracts.


An organization that has a contract with CMS to provide one or more Medicare Advantage (M + C) plans to beneficiaries ([part 422](/cfr/42/part422.md) of this chapter):

- (a) Must acquire and maintain information from Medicare carriers on physicians and practitioners who have opted-out of Medicare.
- (b) Must make no payment directly or indirectly for Medicare covered services furnished to a Medicare beneficiary by a physician or practitioner who has opted-out of Medicare.
- (c) May make payment to a physician or practitioner who furnishes emergency or urgent care services to a beneficiary who has not previously entered into a private contract with the physician or practitioner in accordance with [§ 405.440](/cfr/42/405.440.md).

## Notes

### Amendments

[63 FR 58901, Nov. 2, 1998, as amended at 79 FR 68001, Nov. 13, 2014]

### Authority

Authority: Secs. 1102, 1802, and 1871 of the Social Security Act (42 U.S.C. 1302, 1395a, and 1395hh).

### Source

Source: 63 FR 58901, Nov. 2, 1998, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 263a, 405(a), 1302, 1320b-12, 1395x, 1395y(a), 1395ff, 1395hh, 1395kk, 1395rr, and 1395ww(k).

### Amendments

[63 FR 58901, Nov. 2, 1998, as amended at 79 FR 68001, Nov. 13, 2014]