---
kind: "section"
citation: "42 C.F.R. § 457.1233"
title: "42"
number: "457.1233"
heading: "Structure and operation standards."
url: "https://uscodex.org/cfr/42/457.1233"
---

# §457.1233. Structure and operation standards.

- (a) **Provider selection.** The State must ensure, through its contracts, that each MCO, PIHP or PAHP complies with the provider selection requirements as provided in [§ 438.214](/cfr/42/438.214.md) of this chapter.
- (b) **Subcontractual relationships and delegation.** The State must ensure, through its contracts, that each MCO, PIHP, PAHP, and PCCM entity complies with the subcontractual relationships and delegation requirements as provided in [§ 438.230](/cfr/42/438.230.md) of this chapter.
- (c) **Practice guidelines.** The state must ensure, through its contracts, that each MCO and, when applicable, each PIHP and PAHP, complies with the practice guidelines requirements as provided in [§ 438.236](/cfr/42/438.236.md) of this chapter.
- (d) **Health information systems.** The State must ensure, through its contracts, that each MCO, PIHP, and PAHP complies with the health information systems requirements as provided in [§ 438.242](/cfr/42/438.242.md) of this chapter, except that the applicability date in [§ 438.242(e)](/cfr/42/438.242.md?p=e) of this chapter does not apply. The State is required to submit enrollee encounter data to CMS in accordance with [§ 438.818](/cfr/42/438.818.md) of this chapter.
- (e) **Privacy protections.** The state must ensure, through its contracts, that each MCO, PIHP, and PAHP complies with the privacy protections as provided in [§ 457.1110](/cfr/42/457.1110.md).

## Notes

### Amendments

[81 FR 27897, May 6, 2016, as amended at 82 FR 40, Jan. 3, 2017; 85 FR 25637, May 1, 2020; 85 FR 72842, Nov. 13, 2020]

### Source

Source: 81 FR 27897, May 6, 2016, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 65 FR 33622, May 24, 2000, unless otherwise noted.

### Amendments

[81 FR 27897, May 6, 2016, as amended at 82 FR 40, Jan. 3, 2017; 85 FR 25637, May 1, 2020; 85 FR 72842, Nov. 13, 2020]