e-CFR data is current as of April 15, 2021
TITLE 42—Public Health
CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) SUBCHAPTER I—BASIC HEALTH PROGRAM PART 600—ADMINISTRATION, ELIGIBILITY, ESSENTIAL HEALTH BENEFITS, PERFORMANCE STANDARDS, SERVICE DELIVERY REQUIREMENTS, PREMIUM AND COST SHARING, ALLOTMENTS, AND RECONCILATION
Subpart A—GENERAL PROVISIONS AND DEFINITIONS
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| Definitions and use of terms. |
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Subpart B—ESTABLISHMENT AND CERTIFICATION OF STATE BASIC HEALTH PROGRAMS
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| Basis, scope, and applicability of subpart B. |
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| Development and submission of the BHP Blueprint. |
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| Certification of a BHP Blueprint. |
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| Revisions to a certified BHP Blueprint. |
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| Withdrawal of a BHP Blueprint prior to implementation. |
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| Notice and timing of HHS action on a BHP Blueprint. |
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| State termination of a BHP. |
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| HHS withdrawal of certification and termination of a BHP. |
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| State program administration and operation. |
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| Enrollment assistance and information requirements. |
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| Protections for American Indian and Alaska Natives. |
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| Nondiscrimination standards. |
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| Annual report content and timing. |
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Subpart C—FEDERAL PROGRAM ADMINISTRATION
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| Federal program compliance reviews and audits. |
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Subpart D—ELIGIBILITY AND ENROLLMENT
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| Basis, scope, and applicability. |
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| Certified application counselors. |
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| Determination of eligibility for and enrollment in a standard health plan. |
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| Coordination with other insurance affordability programs. |
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| Periodic redetermination and renewal of BHP eligibility. |
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| Eligibility verification. |
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| Privacy and security of information. |
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Subpart E—STANDARD HEALTH PLAN
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| Basis, scope, and applicability. |
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| Standard health plan coverage. |
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| Competitive contracting process. |
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| Contracting qualifications and requirements. |
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| Enhanced availability of standard health plans. |
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| Coordination with other insurance affordability programs. |
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Subpart F—ENROLLEE FINANCIAL RESPONSIBILITIES
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| Basis, scope, and applicability. |
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| Public schedule of enrollee premium and cost sharing. |
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| General cost-sharing protections. |
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| Disenrollment procedures and consequences for nonpayment of premiums. |
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Subpart G—PAYMENT TO STATES
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| Basis, scope, and applicability. |
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| Secretarial determination of BHP payment amount. |
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| Deposit of Federal BHP payment. |
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Subpart H—BHP TRUST FUND
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| Basis, scope, and applicability. |
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| Fiscal policies and accountability. |
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| Corrective action, restitution, and disallowance of questioned BHP transactions. |
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