# 42 C.F.R. § 411.114 (2026): Determination of nonconformance

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_114

## Section

- **Citation:** 42 C.F.R. § 411.114 (2026)
- **Heading:** Determination of nonconformance
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Title 42 CFR: Public Health / Chapter IV: CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES / Part 411: EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT / Subpart E: Limitations on Payment for Services Covered Under Group Health Plans: General Provisions / § 411.114: § 411.114   Determination of nonconformance.

## Text

(a)
Starting dates for determination of nonconformance.
CMS's authority to determine nonconformance of GHPs begins on the following dates:
(1) On January 1, 1987 for MSP provisions that affect the disabled.
(2) On December 20, 1989 for MSP provisions that affect ESRD beneficiaries and the working aged.
(3) On August 10, 1993 for failure to refund mistaken Medicare primary payments.
(b)
Special rule for failure to repay.
A GHP that fails to comply with § 411.110 (a)(1), (a)(2), or (a)(3) in a particular year is nonconforming for that year. If, in a subsequent year, that plan fails to repay the resulting mistaken primary payments (in accordance with § 411.110(a)(4)), the plan is also nonconforming for the subsequent year. For example, if a plan paid secondary for the working aged in 1991, that plan was nonconforming for 1991. If in 1994 CMS identifies mistaken primary payments attributable to the 1991 violation, and the plan refuses to repay, it is also nonconforming for 1994.

## Nearby sections

- [42 C.F.R. § 411.100 (2026) § 411.100   Basis and scope.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_100.md)
- [42 C.F.R. § 411.101 (2026) § 411.101   Definitions.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_101.md)
- [42 C.F.R. § 411.102 (2026) § 411.102   Basic prohibitions and requirements.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_102.md)
- [42 C.F.R. § 411.103 (2026) § 411.103   Prohibition against financial and other incentives.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_103.md)
- [42 C.F.R. § 411.104 (2026) § 411.104   Current employment status.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_104.md)
- [42 C.F.R. § 411.106 (2026) § 411.106   Aggregation rules.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_106.md)
- [42 C.F.R. § 411.108 (2026) § 411.108   Taking into account entitlement to Medicare.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_108.md)
- [42 C.F.R. § 411.110 (2026) § 411.110   Basis for determination of nonconformance.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_110.md)
- [42 C.F.R. § 411.112 (2026) § 411.112   Documentation of conformance.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_112.md)
- [42 C.F.R. § 411.114 (2026) § 411.114   Determination of nonconformance.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_114.md)
- [42 C.F.R. § 411.115 (2026) § 411.115   Notice of determination of nonconformance.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_115.md)
- [42 C.F.R. § 411.120 (2026) § 411.120   Appeals.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_120.md)
- [42 C.F.R. § 411.121 (2026) § 411.121   Hearing procedures.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_121.md)
- [42 C.F.R. § 411.122 (2026) § 411.122   Hearing officer's decision.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_122.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/CFR_T42_P411_S411_114. Check the current official text before relying on it. Not legal advice.