CMS Pub. 100-16, ch. 10, § 30.1

The scope of Federal preemption is broad. MA standards set forth in 42 CFR 422

supersede any State laws, regulations, contract requirements, or other standards that

would otherwise apply to MA plans, with the exception of licensing laws and regulations

and laws and regulations relating to plan solvency. In other words, unless they pertain to

licensure and/or solvency, State laws and regulations that regulate health plans do not

apply to MA plans offered by MA organizations.

State laws and regulations that are not pre-empted because they relate to ‘‘State

licensing’’ are limited to State requirements for becoming State licensed, and do not

extend to any requirement that the State might impose on licensed health plans that, in the

absence of Federal preemption, must be met as a condition for maintaining a State

license. Examples of State licensing requirements include filing articles of incorporation

with the appropriate State Agency, having a particular organizational structure or

governance (e.g., in some states, being non-profit).

State licensing laws do not extend to rules that govern the activities of health plans on an

ongoing basis even if compliance with such requirements is a condition for retaining a

State license. In other words, States may not purport to exempt a law from preemption on

the grounds that it is a licensure law by imposing requirements not generally associated

with obtaining a license as a condition of retaining a license. For example, a State

licensing law may not be written so as to set forth ongoing marketing, quality assurance,

or network adequacy requirements for MA plans by making such requirements a

condition of retaining a State license.