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CFR

457.902—Definitions

As used in this subpart—
Actuarially sound principles means generally accepted actuarial principles and practices that are applied to determine aggregate utilization patterns, are appropriate for the population and services to be covered, and have been certified by actuaries who meet the qualification standards established by the Actuarial Standards Board.
Fee-for-service entity means any individual or entity that furnishes services under the program on a fee-for-service basis, including health insurance services.
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