Medicare Managed Care Manual (Pub. 100-16), Ch. 11 § 110.4.1
Access to and Continuity of Care
110.4.1 - Access to and Continuity of Care
(Rev. 79, Issued 02-17-06, Effective Date 02-17-06)
MA organizations offering coordinated care plans must:
•
Honor all open authorizations for care;
•
Place outbound calls to affected Medicare beneficiaries scheduled for services and
undergoing treatment plans to coordinate continuation of care;
•
Maintain "network crossover reports," so Medicare beneficiaries can be quickly
reassigned to other plan-contracted providers or groups within the approved
service area; and
•
Provide an opportunity for members undergoing a treatment plan to continue to
see providers that are no longer in the network due to the group insolvency.