42 CFR 447.46
§ 447.46 Timely claims payment by MCOs.
United States · 42 CFR — Public Health · Status: effective
Cite this
- Citation
- 42 CFR 447.46, § 447.46 Timely claims payment by MCOs, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/206456
- Permanent ID
ys:prov:206456@1- SHA-256
e07d8234b5c7d89025f50c8fd071c229ae2c459b95fe946cef8144547f4ee643
The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.
Full text
(a) Basis and scope. This section implements section 1932(f) of the Act by specifying the rules and exceptions for prompt payment of claims by MCOs.
(b) Definitions. “Claim” and “clean claim” have the meaning given those terms in § 447.45.
(c) Contract requirements—(1) Basic rule. A contract with an MCO must provide that the organization will meet the requirements of § 447.45(d)(2) and (d)(3), and abide by the specifications of § 447.45(d)(5) and (d)(6).
(2) Exception. The MCO and its providers may, by mutual agreement, establish an alternative payment schedule.
(3) Alternative schedule. Any alternative schedule must be stipulated in the contract.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.