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us/regulation/42/438/58 — Conflict of interest safeguards · Axiom

Conflict of interest safeguards

2 rules

Sec. 438.58 Conflict of interest safeguards.

(a) As a condition for contracting with MCOs, PIHPs, or PAHPs, a State must have in effect safeguards against conflict of interest on the part of State and local officers and employees and agents of the State who have responsibilities relating to the MCO, PIHP, or PAHP contracts or the enrollment processes specified in Sec. 438.54(b). These safeguards must be at least as effective as the safeguards specified in chapter 21 of the Office of

[[Page 33482]]

Federal Procurement Policy Act (41 U.S.C. 2101-2107).

(b) A State may not use an MCO, PIHP, PAHP, or other contractor to determine beneficiary compliance with the community engagement requirement in part 435, subpart F of this subchapter, unless the entity is not, and has no direct or indirect financial relationship with, an MCO, PIHP, or PAHP that is responsible for providing or arranging for covered services for individuals enrolled with it under its contract with the State.

in view

Whole section

Encodings · 2

community_engagement_determination_contractor_satisfies_conflict_safeguard42 CFR § 438.58 (b) · derived

42 CFR 438.58(b)

name: community_engagement_determination_contractor_satisfies_conflict_safeguard
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 438.58(b)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/438/58
          excerpt: unless the entity is not
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/438/58
          excerpt: has no direct or indirect financial relationship with
versions:
  - effective_from: '0001-01-01'
    formula: >-
      not entity_is_mco_pihp_or_pahp

      and not
      entity_has_direct_or_indirect_financial_relationship_with_service_responsible_mco_pihp_or_pahp

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state_may_use_entity_for_community_engagement_compliance_determination42 CFR § 438.58 (b) · derived

42 CFR 438.58(b)

name: state_may_use_entity_for_community_engagement_compliance_determination
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 438.58(b)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/438/58
          excerpt: >-
            to determine beneficiary compliance with the community engagement
            requirement
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:regulations/42-cfr/438/58#community_engagement_determination_contractor_satisfies_conflict_safeguard
          output: >-
            community_engagement_determination_contractor_satisfies_conflict_safeguard
          hash: sha256:local
versions:
  - effective_from: '0001-01-01'
    formula: >-
      entity_will_determine_beneficiary_community_engagement_compliance

      and
      community_engagement_determination_contractor_satisfies_conflict_safeguard

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▸rulespec code

Shown source

regulations/42-cfr/438/58.yaml

Displaying the canonical repository encoding.

View on GitHub

Rules

community_engagement_determination_contractor_satisfies_conflict_safeguard

Derived(b) in text ↖

source: 42 CFR 438.58(b)

- name: community_engagement_determination_contractor_satisfies_conflict_safeguard
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 438.58(b)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/438/58
            excerpt: unless the entity is not
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/438/58
            excerpt: has no direct or indirect financial relationship with
  versions:
    - effective_from: '0001-01-01'
      formula: >-
        not entity_is_mco_pihp_or_pahp

        and not
        entity_has_direct_or_indirect_financial_relationship_with_service_responsible_mco_pihp_or_pahp

state_may_use_entity_for_community_engagement_compliance_determination

Derived(b) in text ↖

source: 42 CFR 438.58(b)

- name: state_may_use_entity_for_community_engagement_compliance_determination
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 438.58(b)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/438/58
            excerpt: to determine beneficiary compliance with the community engagement requirement
        - path: versions[0].formula
          kind: import
          import:
            target: >-
              us:regulations/42-cfr/438/58#community_engagement_determination_contractor_satisfies_conflict_safeguard
            output: community_engagement_determination_contractor_satisfies_conflict_safeguard
            hash: sha256:local
  versions:
    - effective_from: '0001-01-01'
      formula: |-
        entity_will_determine_beneficiary_community_engagement_compliance
        and community_engagement_determination_contractor_satisfies_conflict_safeguard

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Conflict of interest safeguards

2 rules

Official source

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Sec. 438.58 Conflict of interest safeguards.

[[Page 33482]]

Federal Procurement Policy Act (41 U.S.C. 2101-2107).

in view

Whole section

Encodings · 2

community_engagement_determination_contractor_satisfies_conflict_safeguard42 CFR § 438.58 (b) · derived

42 CFR 438.58(b)

name: community_engagement_determination_contractor_satisfies_conflict_safeguard
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 438.58(b)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/438/58
          excerpt: unless the entity is not
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/438/58
          excerpt: has no direct or indirect financial relationship with
versions:
  - effective_from: '0001-01-01'
    formula: >-
      not entity_is_mco_pihp_or_pahp

      and not
      entity_has_direct_or_indirect_financial_relationship_with_service_responsible_mco_pihp_or_pahp

open in graph ↗

state_may_use_entity_for_community_engagement_compliance_determination42 CFR § 438.58 (b) · derived

42 CFR 438.58(b)

name: state_may_use_entity_for_community_engagement_compliance_determination
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 438.58(b)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/438/58
          excerpt: >-
            to determine beneficiary compliance with the community engagement
            requirement
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:regulations/42-cfr/438/58#community_engagement_determination_contractor_satisfies_conflict_safeguard
          output: >-
            community_engagement_determination_contractor_satisfies_conflict_safeguard
          hash: sha256:local
versions:
  - effective_from: '0001-01-01'
    formula: >-
      entity_will_determine_beneficiary_community_engagement_compliance

      and
      community_engagement_determination_contractor_satisfies_conflict_safeguard

open in graph ↗

▸rulespec code

Shown source

regulations/42-cfr/438/58.yaml

Displaying the canonical repository encoding.

View on GitHub

Rules

community_engagement_determination_contractor_satisfies_conflict_safeguard

Derived(b) in text ↖

source: 42 CFR 438.58(b)

- name: community_engagement_determination_contractor_satisfies_conflict_safeguard
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 438.58(b)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/438/58
            excerpt: unless the entity is not
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/438/58
            excerpt: has no direct or indirect financial relationship with
  versions:
    - effective_from: '0001-01-01'
      formula: >-
        not entity_is_mco_pihp_or_pahp

        and not
        entity_has_direct_or_indirect_financial_relationship_with_service_responsible_mco_pihp_or_pahp

state_may_use_entity_for_community_engagement_compliance_determination

Derived(b) in text ↖

source: 42 CFR 438.58(b)

- name: state_may_use_entity_for_community_engagement_compliance_determination
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 438.58(b)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/438/58
            excerpt: to determine beneficiary compliance with the community engagement requirement
        - path: versions[0].formula
          kind: import
          import:
            target: >-
              us:regulations/42-cfr/438/58#community_engagement_determination_contractor_satisfies_conflict_safeguard
            output: community_engagement_determination_contractor_satisfies_conflict_safeguard
            hash: sha256:local
  versions:
    - effective_from: '0001-01-01'
      formula: |-
        entity_will_determine_beneficiary_community_engagement_compliance
        and community_engagement_determination_contractor_satisfies_conflict_safeguard