US · guidance
CMS Pub. 100-08, ch. 4, § 4.16.4
Risk-Based Provider Payment: Necessary Factors for Protected
Discounts
(Rev. 11032; Issued: 09-30-21; Effective: 10-12-21; Implementation: 11-10-21)
This section applies to UPICs.
If the buyer is a health maintenance organization or a competitive medical plan acting in
accordance with a risk contract or under another state health care program, the buyer
does not need to report the discount, except as otherwise required under the risk contract.
History
(Rev. 11032; Issued: 09-30-21; Effective: 10-12-21; Implementation: 11-10-21)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
ea547dea5095256feee13f96b90013b0042a66e709dbcf2bab0f191aec8946b7
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