Transcription of Medicare Managed Care Manual - CMS
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Medicare Managed Care Manual Chapter 6 - Relationships With Providers Table of Contents (Rev. 82, 04-27-07) Transmittals for Chapter 6 10 - Introduction 20 - Provider Involvement in Policy-Making - Physician Consultation in Medical Policies - Consultation in Development of Credentialing Policies 30 - Written Information on Physician Participation 40 - Interference With Health Care Professionals Advice to Enrollees Prohibited 50 - Provider Anti-Discrimination 60 - Provider Participation - Notice of Reason for Not Granting Participation - Confirmation of Eligibility for Participation in Medicare : Excluded and Opt-Out Provider Checks - Credentialing, Monitoring, and Recredentialing - Suspension, Termination, or Nonrenewal of Physician Contract 70 - Institutional Provider and Supplier Certification 80 - Physician Incentive Plans - Requirements and Limitations - Disclosure of Physician Incentive Plans 90 - Provider indemnification of MA Organization Prohibited 100 - Special Rules for Services Furnish
reimbursement, or indemnification, against any health care professional who is acting within the scope of his or her license or certification under state law, solely on the basis of the license or certification. If an MA organization declines to include a given provider or group of providers in its
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