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e-CFR data is current as of February 23, 2021

Title 42Chapter IVSubchapter DPart 457Subpart L → Subject Group


Title 42: Public Health
PART 457—ALLOTMENTS AND GRANTS TO STATES
Subpart L—Managed Care


Enrollee Rights and Protections

§457.1220   Enrollee rights.

The State must ensure, through its contracts, that each MCO, PIHP, PAHP, PCCM, and PCCM entity follow the enrollee rights requirements in accordance with the terms of §438.100 of this chapter.

§457.1222   Provider-enrollee communication.

The State must ensure, through its contracts, that each MCO, PIHP, and PAHP protects communications between providers and enrollees in accordance with the terms of §438.102 of this chapter.

§457.1224   Marketing activities.

The State must ensure, through its contracts, that each MCO, PIHP, PAHP, PCCM, and PCCM entity follows the requirements related to marketing activities in accordance with the terms of §438.104 of this chapter, except §438.104(c) of this chapter related to state agency review does not apply.

§457.1226   Liability for payment.

The State must ensure, through its contracts, that enrollees of MCOs, PIHPs, and PAHPs are not held liable for services or debts of the MCO, PIHP, or PAHPs in accordance with the terms of §438.106 of this chapter.

§457.1228   Emergency and poststabilization services.

The State must ensure that emergency and poststabilization care services are available and accessible to enrollees in accordance with the terms of §438.114 of this chapter.

[82 FR 40, Jan. 3, 2017]

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