[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR411.130]



[Page 405]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 411_EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT

--Table of Contents

 

Subpart E_Limitations on Payment for Services Covered Under Group Health 

                        Plans: General Provisions

 

Sec. 411.130  Referral to Internal Revenue Service (IRS).



    (a) CMS responsibility. After CMS determines that a plan has been a 

nonconforming GHP in a particular year, it refers its determination to 

the IRS, but only after the parties have exhausted all CMS appeal rights 

with respect to the determination.

    (b) IRS responsibility. The IRS administers section 5000 of the IRC, 

which imposes a tax on employers (other than governmental entities) and 

employee organizations that contribute to a nonconforming GHP. The tax 

is equal to 25 percent of the employer's or employee organization's 

expenses, incurred during the calendar year in which the plan is a 

nonconforming GHP, for each GHP, both conforming and nonconforming, to 

which the employer or employee organization contributes.