42 C.F.R. § 447.362

Upper limits of payment: Nonrisk contract.

Last amended: 2017Year: 2026Length: 61 wordsSubsections: 2Official source

Cite as 42 C.F.R. § 447.362 (2026)

Under a nonrisk contract, Medicaid payments to the contractor may not exceed— (a) What Medicaid would have paid, on a fee-for-service basis, for the services actually furnished to beneficiaries: plus (b) The net savings of administrative costs the Medicaid agency achieves by contracting with the plan instead of purchasing the services on a fee-for-service basis. [48 FR 54025, Nov. 30, 1983]
42 C.F.R. § 447.362: Upper limits of payment: Nonrisk contract. | Justis AI