§ 438.1 Basis and scope
§ 438.2 Definitions
§ 438.3 Standard contract requirements
§ 438.4 Actuarial soundness
§ 438.5 Rate development standards
§ 438.6 Special contract provisions related to payment
§ 438.7 Rate certification submission
§ 438.8 Medical loss ratio (MLR) standards
§ 438.9 Provisions that apply to non-emergency medical transportation PAHPs
§ 438.10 Information requirements
§ 438.12 Provider discrimination prohibited
§ 438.14 Requirements that apply to MCO, PIHP, PAHP, PCCM, and PCCM entity contracts involving Indians, Indian health care providers (IHCPs), and Indian managed care entities (IMCEs)

Terms Used In CFR > Title 42 > Chapter IV > Subchapter C > Part 438 > Subpart A - General Provisions

  • Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Contract: A legal written agreement that becomes binding when signed.
  • Fraud: Intentional deception resulting in injury to another.
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Statute: A law passed by a legislature.