42 C.F.R. § 417.484

Current through November 30, 2024
Section 417.484 - Requirement applicable to related entities
(a)Definition. As used in this section, related entity means any entity that is related to the HMO or CMP by common ownership or control and-
(1) Performs some of the HMO's or CMP's management functions under contract or delegation;
(2) Furnishes services to Medicare enrollees under an oral or written agreement; or
(3) Leases real property or sells materials to the HMO or CMP at a cost of more than $2,500 during a contract period.
(b)Requirement. The contract must provide that the HMO or CMP agrees to require all related entities to agree that-
(1) HHS, the Comptroller General, or their designees have the right to inspect, evaluate, and audit any pertinent books, documents, papers, and records of the subcontractor involving transactions related to the subcontract; and
(2) The right under paragraph (b)(1) of this section to information for any particular contract period will exist for a period equivalent to that specified in § 417.482(f) .
(3) That payments must not be made to individuals and entities included on the preclusion list, defined in § 422.2 of this chapter.

42 C.F.R. §417.484

50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993; 81 FR 80556 , Nov. 15, 2016; 83 FR 16721 , Apr. 16, 2018
81 FR 80556 , 1/1/2017; 83 FR 16721 , 6/15/2018