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Content Section
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Publication # |
100-16 |
Title |
Medicare Managed Care Manual |
| Downloads | Chapter 1 - General Provisions [PDF, 105 KB]
Chapter 2 - Click here for Enrollment and Disenrollment Instructions [PDF, 754 KB]
Chapter 3 - Click here for Marketing Guides Instructions
Chapter 4 - Benefits and Beneficiary Protections [PDF, 249 KB]
Chapter 5 - Quality Assessment [PDF, 447 KB]
Chapter 6 - Relationships With Providers [PDF, 146 KB]
Chapter 7 - Payments to Medicare+Choice Organizations
Chapter 8 - Payments to Medicare Advantage Organizations [PDF 236 KB]
Chapter 9 - Employer/Union Sponsored Group Health Plans [PDF, 575KB]
Chapter 10 - MA Organization Compliance with State Law and Preemption by Federal Law [PDF, 32 KB]
Chapter 11 - Medicare Advantage Application Procedures and Contract Requirements [PDF, 294 KB]
Chapter 12 - Effect of Change of Ownership [PDF, 75 KB]
Chapter 13 - Medicare Managed Care Beneficiary Grievances, Organization Determinations, and Appeals Applicable to Medicare Advantage Plans, Cost Plans, and Health Care Prepayment Plans (HCPPs), (collectively referred to as Medicare Health Plans) [PDF, 275 KB]
Chapter 14 - Contract Determinations and Appeals [PDF, 74 KB]
Chapter 15 - Intermediate Sanctions [PDF, 57 KB]
Chapter 16 - Reserved
Chapter 17 - Cost Based Payment 17a - Subchapter A - TEFRA Cost Based Payment Processes and Principles [PDF, 132 KB] 17b - Subchapter B - Payment Principles for Cost Based HMOs and CMPs [PDF, 283 KB] 17c - Subchapter C - Cost Apportionment for Cost Based HMOs and CMPs [PDF, 60 KB] 17d - Subchapter D - Medicare Cost Plan Enrollment and Disenrollment Instructions [PDF, 381 KB] 17f - Subchapter F - Benefits and Beneficiary Protections [PDF, 227 KB]
Chapter 18 - Health Care Prepayment Plans 18a - Subchapter A - Cost-Based Payment Process and Principles [PDF, 100 KB] 18b - Subchapter B - Payment Principles for Cost Based HMOs and CMPs [PDF, 234 KB] 18c - Subchapter C - Cost Apportionment for Cost-Based HMO/CMPs [PDF, 145 KB]
Chapter 19 - The Enrollment and Payment User's Guide-Available Spring 2009
Chapter 20 - Plan Communications Guide-Available Spring 2009
| Related Links Inside CMS | Part C Marketing Guide Lines
| Related Links Outside CMS | | There are no Related Links Outside CMS
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