---
kind: "section"
citation: "42 C.F.R. § 438.106"
title: "42"
number: "438.106"
heading: "Liability for payment."
url: "https://uscodex.org/cfr/42/438.106"
---

# §438.106. Liability for payment.


Each MCO, PIHP, and PAHP must provide that its Medicaid enrollees are not held liable for any of the following:

- (a) **The MCO's, PIHP's, or PAHP's debts, in the event of the entity's insolvency.**
- (b) **Covered services provided to the enrollee, for which—**
  - (1) The State does not pay the MCO, PIHP, or PAHP; or
  - (2) The State, or the MCO, PIHP, or PAHP does not pay the individual or health care provider that furnished the services under a contractual, referral, or other arrangement.
- (c) Payments for covered services furnished under a contract, referral, or other arrangement, to the extent that those payments are in excess of the amount that the enrollee would owe if the MCO, PIHP, or PAHP covered the services directly.

## Notes

### Source

Source: 81 FR 27853, May 6, 2016, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 67 FR 41095, June 14, 2002, unless otherwise noted.