42 CFR § 457.950 - Contract and payment requirements including certification of payment-related information.

---
identifier: "/us/cfr/t42/s457.950"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 457.950 - Contract and payment requirements including certification of payment-related information."
title_number: 42
title_name: "Public Health"
section_number: "457.950"
section_name: "Contract and payment requirements including certification of payment-related information."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "D"
subchapter_name: "STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs)"
part_number: "457"
part_name: "ALLOTMENTS AND GRANTS TO STATES"
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."
regulatory_source: "65 FR 33622, May 24, 2000, unless otherwise noted."
cfr_part: "457"
---


# 457.950 Contract and payment requirements including certification of payment-related information.

(a) *MCOs, PAHPs, PIHPs, PCCMs, and PCCM entities.* The contract requirements for MCOs, PAHPs, PIHPs, PCCMs, and PCCM entities are provided in § 457.1201.

(b) *Fee-for-service entities.* A State that makes payments to fee-for-service entities under a separate child health program must—

(1) Establish procedures to ensure that the entity certifies and attests that information on claim forms is truthful, accurate, and complete;

(2) Ensure that fee-for-service entities understand that payment and satisfaction of the claims will be from Federal and State funds, and that any false claims may be prosecuted under applicable Federal or State laws; and

(3) Require, as a condition of participation, that fee-for-service entities provide the State, CMS and/or the HHS Office of the Inspector General with access to enrollee health claims data, claims payment data and related records.

[66 FR 2685, Jan. 11, 2001, as amended at 81 FR 27897, May 6, 2016]