42 CFR 421.3
§ 421.3 Definitions.
United States · 42 CFR — Public Health · Status: effective
Cite this
- Citation
- 42 CFR 421.3, § 421.3 Definitions, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/204453
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Full text
As used in this part—
Intermediary means an entity that has a contract with CMS (under statutory provisions in effect prior to October 1, 2005) to determine and make Medicare payments for Part A or Part B benefits payable on a cost basis (or under the prospective payment system for hospitals) and to perform other related functions. For purposes of applying the performance criteria in § 421.120 and the performance standards in § 421.122 and any adverse action resulting from that application, the term “intermediary” also means a Blue Cross plan that has entered into a subcontract approved by CMS with the Blue Cross and Blue Shield Association to perform intermediary functions.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.