42 C.F.R. § 423.2470

Remittance to CMS if the applicable MLR requirement is not met.

Last amended: 2017Year: 2026Length: 132 wordsSubsections: 4Official source

Cite as 42 C.F.R. § 423.2470 (2026)

(a) General requirement. For each contract year, a Part D sponsor must provide a remittance to CMS if the contract's MLR does not meet the minimum percentage required by § 423.2410(b). (b) Amount of remittance. For each contract that does not meet MLR requirement for a contract year, the Part D sponsor must remit to CMS the amount by which the MLR requirement exceeds the contract's actual MLR multiplied by the total revenue of the contract, as provided in § 423.2420(c), for the contract year. (c) Timing of remittance. CMS will deduct the remittance from plan payments in a timely manner after the MLR is reported, on a schedule determined by CMS. (d) Treatment of remittance. Payment to CMS must not be included in the numerator or denominator of any year's MLR.
Cross-references to the CFR
423.2410423.2420
42 C.F.R. § 423.2470: Remittance to CMS if the applicable MLR requirement is not met. | Justis AI