42 CFR 417.486
§ 417.486 Disclosure of information and confidentiality.
United States · 42 CFR — Public Health · Status: effective
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- Citation
- 42 CFR 417.486, § 417.486 Disclosure of information and confidentiality, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/204241
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Full text
The contract must provide that the HMO or CMP agrees to the following:
(a) To submit to CMS—
(1) All financial information required under subpart O of this part and for final settlement;
(2) Any other information necessary for the administration or evaluation of the Medicare program; and
(3) Risk adjustment data as specified in § 422.310 of this chapter for the purposes of determining an individual's health status. In applying this paragraph (a)(3), references to Medicare Advantage (MA) organizations in § 422.310 must be read to mean HMOs and CMPs.
(b) To comply with the requirements set forth in part 420, subpart C, of this chapter pertaining to the disclosure of ownership and control information.
(c) To comply with the requirements of the Privacy Act, as implemented by 45 CFR part 5b and subpart B of part 401 of this chapter, with respect to any system of records developed in performing carrier or intermediary functions under §§ 417.532 and 417.533.
(d) To meet the confidentiality requirements of § 482.24(b)(3) of this chapter for medical records and for all other enrollee information that is—
(1) Contained in its records or obtained from CMS or other sources; and
(2) Not covered under paragraph (c) of this section.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.