42 C.F.R. § 438.708

Current through November 30, 2024

Section 438.708 - Termination of an MCO, PCCM or PCCM entity contract

A State has the authority to terminate an MCO, PCCM or PCCM entity contract and enroll that entity's enrollees in other MCOs, PCCMs or PCCM entities, or provide their Medicaid benefits through other options included in the State plan, if the State determines that the MCO, PCCM or PCCM entity has failed to do either of the following:

(a) Carry out the substantive terms of its contract.

(b) Meet applicable requirements in sections 1932, 1903(m), and 1905(t) of the Act.

42 C.F.R. §438.708

81 FR 27852 , 5/6/2016