[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR434.6]



[Page 110-111]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 434_CONTRACTS--Table of Contents

 

                      Subpart A_General Provisions

 

Sec.  434.6  General requirements for all contracts and subcontracts.



    (a) Contracts. All contracts under this part must--

    (1) Include provisions that define a sound and complete procurement 

contract, as required by 45 CFR part 74;

    (2) Identify the population covered by the contract;

    (3) Specify any procedures for enrollment or reenrollment of the 

covered population;

    (4) Specify the amount, duration, and scope of medical services to 

be provided or paid for;

    (5) Provide that the agency and HHS may evaluate through inspection 

or other means, the quality, appropriateness and timeliness of services 

performed under the contract;

    (6) Specify procedures and criteria for terminating the contract, 

including a requirement that the contractor promptly supply all 

information necessary for the reimbursement of any outstanding Medicaid 

claims;



[[Page 111]]



    (7) Provide that the contractor maintains an appropriate record 

system for services to enrolled recipients;

    (8) Provide that the contractor safeguards information about 

recipients as required by part 431, subpart F of this chapter;

    (9) Specify any activities to be performed by the contractor that 

are related to third party liability requirements in part 433, subpart D 

of this chapter;

    (10) Specify which functions may be subcontracted; and

    (11) Provide that any subcontracts meet the requirements of 

paragraph (b) of this section.

    (b) Subcontracts. All subcontracts must be in writing and fulfill 

the requirements of this part that are appropriate to the service or 

activity delegated under the subcontract.

    (c) Continued responsibility of contractor. No subcontract 

terminates the legal responsibility of the contractor to the agency to 

assure that all activities under the contract are carried out.



[48 FR 54020, Nov. 30, 1983, as amended at 67 FR 41095, June 14, 2002]