42 CFR § 422.404 - State premium taxes prohibited.

---
identifier: "/us/cfr/t42/s422.404"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 422.404 - State premium taxes prohibited."
title_number: 42
title_name: "Public Health"
section_number: "422.404"
section_name: "State premium taxes prohibited."
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"
---


# 422.404 State premium taxes prohibited.

(a) *Basic rule.* No premium tax, fee, or other similar assessment may be imposed by any State, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, and American Samoa, or any of their political subdivisions or other governmental authorities with respect to any payment CMS makes on behalf of MA enrollees under subpart G of this part, or with respect to any payment made to MA plans by beneficiaries, or payment to MA plans by a third party on a beneficiary's behalf.

(b) *Construction.* Nothing in this section shall be construed to exempt any MA organization from taxes, fees, or other monetary assessments related to the net income or profit that accrues to, or is realized by, the organization from business conducted under this part, if that tax, fee, or payment is applicable to a broad range of business activity.

[63 FR 35099, June 26, 1998, as amended at 70 FR 4733, Jan. 28, 2005]