Transcription of Medicare Managed Care Manual - CMS
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Medicare Managed Care Manual - CMS
Medicare Managed Care Manual Chapter 11 - Medicare Advantage Application Procedures and Contract Requirements (Rev. 83, 04-25-2007) NOTE: This chapter addresses Medicare Advantage contract requirements only, and does not address Medicare cost-based Managed care contract requirements. Information on Medicare cost-based contract requirements can be found in Chapter 17. Table of Contents Transmittals for Chapter 1101 - Introduction 10 - Definitions 20 - General Medicare Advantage Application and Contract Provisions - Application Procedures and Conditions for Entering an MA - Evaluation and Determination of Applications - Monitoring and Promoting Staff and Affiliated provider Compliance with Policies 30 - Minimum Enrollment Requirements for MA Organizations - Minimum Enrollment Waiver 40 - Term and Effective Date of an MA Contract 50 - Contracting Prohibitions Under the Medicare Advantage (MA) Program 60 - MA Contract Renewal - MA Contracts are Automatically Renewed70 - Contract Nonrenewal - Nonrenewal of MA Contract: MA Organization-Initiated - Responsibilities of Nonrenewing MA Organizations - Nonrenewal of MA Contract.
100.4 - Provider and Supplier Contract Requirements 100.5 - Administrative Contracting Requirements 100.6 - Implementation of Written Policies With Respect to the Enrollee Rights 110 - MA Organization Relationship with Related Entities, Contractors, Subcontractors, First-Tier and Downstream Entities 110.1 - General Requirements
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