Regulations last checked for updates: Nov 22, 2024

Title 45 - Public Welfare last revised: Nov 19, 2024
§ 154.210 - Review of rate increases subject to review by CMS or by a State.

(a) Except as provided in paragraph (b) of this section, CMS will review a rate increase subject to review to determine whether it is unreasonable, as required by this part.

(b) CMS will adopt a State's determination of whether a rate increase is an unreasonable rate increase, if the State:

(1) Has an Effective Rate Review Program as described in § 154.301; and

(2) The State provides to CMS, on a form and in a manner prescribed by the Secretary, its final determination of whether a rate increase is unreasonable, which must include a brief explanation of how its analysis of the relevant factors set forth in § 154.301(a)(3) caused it to arrive at that determination, within five business days following the State's final determination.

(c) CMS will post and maintain on its Web site a list of the States with market segments that meet the requirements of paragraph (b) of this section.

authority: Section 2794 of the Public Health Service Act (42 USC 300gg-94)
source: 76 FR 29985, May 23, 2011, unless otherwise noted.
cite as: 45 CFR 154.210