C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 417—HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS › Subpart K—Enrollment, Entitlement, and Disenrollment under Medicare Contract

42 C.F.R. § 417.428

Marketing activities

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(a) With the exception of § 422.2276 of this chapter, the procedures and requirements relating to marketing requirements set forth in subpart V of part 422 of this chapter also apply to Medicare contracts with HMOs and CMPs under section 1876 of the Act.

(b) In applying those provisions, references to part 422 of this chapter must be read as references to this part, and references to MA organizations as references to HMOs and CMPs.

[75 FR 19802, Apr. 15, 2010]
Notes of Decisions
Cited in 2 cases, 1992–2003 · leading case: United States Ex Rel. Willard v. Humana Health Plan of Texas Inc., 336 F.3d 375 (5th Cir. 2003).
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United States Ex Rel. Willard v. Humana Health Plan of Texas Inc., 336 F.3d 375 (5th Cir. 2003). · cites it 3× “§ 1395mm(i)(6)(a)(iv); 42 C.F.R. § 417.428 (b)(1). Willard contends that, fairly read, its Second Amended Complaint alleges that Humana engaged in a “cher-rypicking” scheme “whereby less healthy potential program participants and those living in counties outside Humana’s favored…”
Lutheran Med. Ctr. v. Elderplan, Inc., 155 Misc. 2d 887 (N.Y. City Civ. Ct. 1992). “428 of the Health Care Financing Administration regulations (42 CFR 417.428) which requires HMOs to offer its enrollees adequate written description of its rules and benefits and to submit all marketing materials to the Health Care Financing Administration at least 45 days…”
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