45 CFR Part 800
PART 800—MULTI-STATE PLAN PROGRAM
- PART 800—MULTI-STATE PLAN PROGRAM
- Subtitle B—Regulations Relating to Public Welfare › Chapter VIII—Office of Personnel Management
- Subpart A—General Provisions and Definitions
- § 800.10 Basis and scope.
- § 800.20 Definitions.
- Subpart B—Multi-State Plan Program Issuer Requirements
- § 800.101 General requirements.
- § 800.102 Compliance with Federal law.
- § 800.103 Authority to contract with issuers.
- § 800.104 Phased expansion, etc.
- § 800.105 Benefits.
- § 800.106 Cost-sharing limits, advance payments of premium tax credits, and cost-sharing reductions.
- § 800.107 Levels of coverage.
- § 800.108 Assessments and user fees.
- § 800.109 Network adequacy.
- § 800.110 Service area.
- § 800.111 Accreditation requirement.
- § 800.112 Reporting requirements.
- § 800.113 Benefit plan material or information.
- § 800.114 Compliance with applicable State law.
- § 800.115 Level playing field.
- § 800.116 Process for dispute resolution.
- Subpart C—Premiums, Rating Factors, Medical Loss Ratios, and Risk Adjustment
- § 800.201 General requirements.
- § 800.202 Rating factors.
- § 800.203 Medical loss ratio.
- § 800.204 Reinsurance, risk corridors, and risk adjustment.
- Subpart D—Application and Contracting Procedures
- § 800.301 Application process.
- § 800.302 Review of applications.
- § 800.303 MSP Program contracting.
- § 800.304 Term of the contract.
- § 800.305 Contract renewal process.
- § 800.306 Nonrenewal.
- Subpart E—Compliance
- § 800.401 Contract performance.
- § 800.402 Contract quality assurance.
- § 800.403 Fraud and abuse.
- § 800.404 Compliance actions.
- § 800.405 Reconsideration of compliance actions.
- Subpart F—Appeals by Enrollees of Denials of Claims for Payment or Service
- § 800.501 General requirements.
- § 800.502 MSP issuer internal claims and appeals.
- § 800.503 External review.
- § 800.504 Judicial review.
- Subpart G—Miscellaneous
- § 800.601 Reservation of authority.
- § 800.602 Consumer choice with respect to certain services.
- § 800.603 Disclosure of information.
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