---
kind: "section"
citation: "42 C.F.R. § 422.2410"
title: "42"
number: "422.2410"
heading: "General requirements."
url: "https://uscodex.org/cfr/42/422.2410"
---

# §422.2410. General requirements.

- (a) For contracts beginning in 2014 or later, an MA organization (defined at [§ 422.2](/cfr/42/422.2.md)) is required to report the information required under [§ 422.2460](/cfr/42/422.2460.md) for each contract under this part for each contract year.
- (b) **MLR requirement.** If CMS determines for a contract year that an MA organization has an MLR for a contract that is less than 0.85, the MA organization has not met the MLR requirement and must remit to CMS an amount equal to the product of the following:
  - (1) **The total revenue of the MA contract for the contract year.**
  - (2) The difference between 0.85 and the MLR for the contract year.
- (c) If CMS determines that an MA organization has an MLR for a contract that is less than 0.85 for 3 or more consecutive contract years, CMS does not permit the enrollment of new enrollees under the contract for coverage during the second succeeding contract year.
- (d) If CMS determines that an MA organization has an MLR for a contract that is less than 0.85 for 5 consecutive contract years, CMS terminates the contract per § [422.510(b)(1)](/cfr/42/422.510.md?p=b-1) and [(d)](/cfr/42/422.510.md?p=b-d) effective as of the second succeeding contract year.

## Notes

### Amendments

[78 FR 31307, May 23, 2013, as amended at 83 FR 16736, Apr. 16, 2018]

### Source

Source: 78 FR 31307, May 23, 2013, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302, 1306, 1395w-21 through 1395w-28, and 1395hh.

### Source

Source: 63 FR 18134, Apr. 14, 1998, unless otherwise noted.

### Amendments

[78 FR 31307, May 23, 2013, as amended at 83 FR 16736, Apr. 16, 2018]