---
kind: "section"
citation: "42 C.F.R. § 417.524"
title: "42"
number: "417.524"
heading: "Payment to HMOs or CMPs: General."
url: "https://uscodex.org/cfr/42/417.524"
---

# §417.524. Payment to HMOs or CMPs: General.

- (a) **Basic rule.** The payments that CMS makes to an HMO or CMP under this subpart and subparts [O](/cfr/42/subpartO.md) and [P](/cfr/42/subpartP.md) of this part for furnishing covered Medicare services are in place of any payment that CMS would otherwise make to a beneficiary or the HMO or CMP under sections [1814(b)](/cfr/42/1814.md?p=b) and [1833(a)](/cfr/42/1833.md?p=a) of the Act.
- (b) **Basis of payment.**
  - (1) CMS pays the HMOs or CMPs on either a reasonable cost basis or a risk basis depending on the type of contract the HMO or CMP has with CMS.
  - (2) In certain cases a risk HMO or CMP also receives payments on a reasonable cost basis for certain Medicare enrollees who retain nonrisk status, as provided in [§ 417.444](/cfr/42/417.444.md), after the HMO or CMP enters into a risk contract.

## Notes

### Amendments

[60 FR 46229, Sept. 6, 1995]

### Authority

Authority: 42 U.S.C. 1302 and 1395hh, and 300e, 300e-5, and 300e-9, and 31 U.S.C. 9701.

### Amendments

[60 FR 46229, Sept. 6, 1995]