§447.362. Upper limits of payment: Nonrisk contract.
42 C.F.R. § 447.362
Under a nonrisk contract, Medicaid payments to the contractor may not exceed—
What Medicaid would have paid, on a fee-for-service basis, for the services actually furnished to beneficiaries: plus
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.
Notes, amendments, and revision history
Amendments
[48 FR 54025, Nov. 30, 1983]
Source
Source: 43 FR 45253, Sept. 29, 1978, unless otherwise noted. Redesignated at 46 FR 47973, Sept. 30, 1981, and further redesignated at 58 FR 6095, Jan. 26, 1993.
Authority
Authority: 42 U.S.C. 1302, and 1396r-8, and Pub. L. 111-148.
Source
Source: 43 FR 45253, Sept. 29, 1978, unless otherwise noted.
Amendments
[48 FR 54025, Nov. 30, 1983]