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Title 42

Displaying title 42, up to date as of 8/06/2026. Title 42 was last amended 8/05/2026.
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Title 42Public HealthPart / Section
Chapter IVCenters for Medicare & Medicaid Services, Department of Health and Human Services400 – 699
Subchapter DState Children's Health Insurance Programs (SCHIPs)457
Part 457Allotments and Grants to States457.1 – 457.1285
Subpart LManaged Care457.1200 – 457.1285
General Provisions457.1200 – 457.1209
§ 457.1200Basis, scope, and applicability.
§ 457.1201Standard contract requirements.
§ 457.1203Rate development standards and medical loss ratio.
§ 457.1206Non-emergency medical transportation PAHPs.
§ 457.1207Information requirements.
§ 457.1208Provider discrimination prohibited.
§ 457.1209Requirements that apply to MCO, PIHP, PAHP, PCCM, and PCCM entity contracts involving Indians, Indian health care provider (IHCP), and Indian managed care entities (IMCE).
State Responsibilities457.1210 – 457.1218
§ 457.1210Enrollment process.
§ 457.1212Disenrollment.
§ 457.1214Conflict of interest safeguards.
§ 457.1216Continued services to enrollees.
§ 457.1218Network adequacy standards.
Enrollee Rights and Protections457.1220 – 457.1228
§ 457.1220Enrollee rights.
§ 457.1222Provider-enrollee communication.
§ 457.1224Marketing activities.
§ 457.1226Liability for payment.
§ 457.1228Emergency and poststabilization services.
MCO, PIHP, and PAHP Standards457.1230 – 457.1233
§ 457.1230Access standards.
§ 457.1233Structure and operation standards.
Quality Measurement and Improvement; External Quality Review457.1240 – 457.1250
§ 457.1240Quality measurement and improvement.
§ 457.1250External quality review.
Grievance System457.1260
§ 457.1260Grievance system.
Sanctions457.1270 – 457.1285
§ 457.1270Sanctions.
§ 457.1280Conditions necessary to contract as an MCO, PAHP, or PIHP.
§ 457.1285Program integrity safeguards.