[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: 42CFR455.105]



[Page 337-338]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 455_PROGRAM INTEGRITY: MEDICAID--Table of Contents

 

   Subpart B_Disclosure of Information by Providers and Fiscal Agents

 

Sec.  455.105  Disclosure by providers: Information related to business 



transactions.



    (a) Provider agreements. A Medicaid agency must enter into an 

agreement with each provider under which the provider agrees to furnish 

to it or to the Secretary on request, information



[[Page 338]]



related to business transactions in accordance with paragraph (b) of 

this section.

    (b) Information that must be submitted. A provider must submit, 

within 35 days of the date on a request by the Secretary or the Medicaid 

agency, full and complete information about--

    (1) The ownership of any subcontractor with whom the provider has 

had business transactions totaling more than $25,000 during the 12-month 

period ending on the date of the request; and

    (2) Any significant business transactions between the provider and 

any wholly owned supplier, or between the provider and any 

subcontractor, during the 5-year period ending on the date of the 

request.

    (c) Denial of Federal financial participation (FFP). (1) FFP is not 

available in expenditures for services furnished by providers who fail 

to comply with a request made by the Secretary or the Medicaid agency 

under paragraph (b) of this section or under Sec.  420.205 of this 

chapter (Medicare requirements for disclosure).

    (2) FFP will be denied in expenditures for services furnished during 

the period beginning on the day following the date the information was 

due to the Secretary or the Medicaid agency and ending on the day before 

the date on which the information was supplied.