42 CFR § 422.400 - State licensure requirement.

---
identifier: "/us/cfr/t42/s422.400"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 422.400 - State licensure requirement."
title_number: 42
title_name: "Public Health"
section_number: "422.400"
section_name: "State licensure requirement."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "B"
subchapter_name: "MEDICARE PROGRAM"
part_number: "422"
part_name: "MEDICARE ADVANTAGE PROGRAM"
positive_law: false
currency: "2026-04-05"
last_updated: "2026-04-05"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302, 1306, 1395w-21 through 1395w-28, and 1395hh."
regulatory_source: "63 FR 18134, Apr. 14, 1998, unless otherwise noted."
cfr_part: "422"
---


# 422.400 State licensure requirement.

Except in the case of a PSO granted a waiver under subpart H of this part, each MA organization must—

(a) Be licensed under State law, or otherwise authorized to operate under State law, as a risk-bearing entity (as defined in § 422.2) eligible to offer health insurance or health benefits coverage in each State in which it offers one or more MA plans;

(b) If not commercially licensed, obtain certification from the State that the organization meets a level of financial solvency and such other standards as the State may require for it to operate as an MA organization; and

(c) Demonstrate to CMS that—

(1) The scope of its license or authority allows the organization to offer the type of MA plan or plans that it intends to offer in the State; and

(2) If applicable, it has obtained the State certification required under paragraph (b) of this section.