U.S. Code of Federal Regulations
Introduction
U.S. Code of Federal Regulations
Title 42 - Chapter IV - Subchapter C
Part 438 - Managed Care
Subpart A (General Provisions)
- 42 CFR Section 438.3(s): Requirements for MCOs, PIHPs, or PAHPs that provide covered outpatient drugs
Part 440 - Services: General Provisions
Subpart A (Definitions)
- 42 CFR Section 440.70: Home Health Services
- 42 CFR Section 440.120: Prescribed drugs, dentures, prosthetic devices, and eyeglasses
Part 447 - Payments for Services
Subpart I (Payment for Drugs)
- 42 CFR Section 447.500: Basis and Purpose
- 42 CFR Section 447.502: Definitions
- 42 CFR Section 447.504: Determination of average manufacturer price
- 42 CFR Section 447.505: Determination of Best Price
- 42 CFR Section 447.506: Authorized Generic Drugs
- 42 CFR Section 447.508: Exclusion from Best Price Of Certain Sales At A Nominal Price
- 42 CFR Section 447.510: Requirements for Manufacturers
- 42 CFR Section 447.512: Drugs: Aggregate Upper Limits of Payment
- 42 CFR Section 447.516: Upper Limits For Drugs Furnished As Part of Services
- 42 CFR Section 447.518: State Plan Requirements, Findings and Assurances
- 42 CFR Section 447.520: FFP: Conditions Relating To Physician-Administered Drugs
Part 456 - Utilization Control
Subpart K (Drug Use Review Program and Electronic Claims Management System for Outpatient Drug Claims)
- 42 CFR Section 456.700: Scope
- 42 CFR Section 456.702: Definitions
- 42 CFR Section 456.703: Drug Use Review Program
- 42 CFR Section 456.705: Prospective Drug Review
- 42 CFR Section 456.709: Retrospective Drug Use Review
- 42 CFR Section 456.711: Educational Program
- 42 CFR Section 456.712: Annual Report
- 42 CFR Section 456.714: DUR/Surveillance And Utilization Review Relationship
- 42 CFR Section 456.716: DUR Board
- 42 CFR Section 456.719: Funding For Dur Program
- 42 CFR Section 456.722: Electronic Claims Management System
- 42 CFR Section 456.725: Funding Of ECM System