C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 421—MEDICARE CONTRACTING › Subpart E—Medicare Administrative Contractors (MACs)

42 C.F.R. § 421.400

Statutory basis and scope

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(a) Statutory basis. This subpart implements section 1874A of the Act, which provides for the transition of the claims processing functions and operations for both Medicare Part A and Part B intermediaries and carriers to Medicare Administrative Contractors (MACs). The transition will occur between October 1, 2005, and October 1, 2011. MACs will be fully operational in distinct, nonoverlapping geographic jurisdictions by October 1, 2011.

(b) Scope. This subpart specifies the requirements under which providers and suppliers will be assigned to MACs.

Notes of Decisions
Cited in 4 cases (2 in the last 5 years), 2012–2025 · leading case: Nichole Med. Equip. & Supply, Inc. v. Tricenturion, Inc., 694 F.3d 340 (3rd Cir. 2012).
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Nichole Med. Equip. & Supply, Inc. v. Tricenturion, Inc., 694 F.3d 340 (3rd Cir. 2012). “See 42 C.F.R. § 421.400 (a). The conduct underlying Nichole Medical's complaint begins as early as 2002.”
Accident, Injury & Rehab., PC v. Azar, 336 F. Supp. 3d 599 (D.S.C. 2018). “§ 1395kk-1 ; 42 C.F.R. § 421.400 et seq. ; 71 F.R. 67960 -01, at 68181 (Nov.”
United States of Am. v. Odom (D.S.C. 2021). “42 C.F.R. §§ 421.400 , 401, 404. At all relevant times during the instant case, the MAC authorized to process claims by Medicare Part B providers and suppliers in South Carolina was Palmetto GBA.”
Medica Ins. Co. v. Becerra (D.D.C. 2025). “See 42 C.F.R. 421.400. As is relevant here, a Part B enrollee may alternatively receive benefits though a “health maintenance organization” (HMO) that has contracted with the Secretary to provide Part B services through in-network suppliers.”
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