Minimum Enrollment Requirements for MA Organizations

30 - Minimum Enrollment Requirements for MA Organizations (Rev. 79, Issued 02-17-06, Effective Date 02-17-06) Unless an organization has a minimum enrollment waiver as explained below, CMS does not enter into a contract with an entity unless it meets the following minimum enrollment requirements: • At least 5,000 individuals (or 1,500 individuals if the organization is a PSO) are enrolled for the purpose of receiving health benefits from the organization; or • At least 1,500 individuals (or 500 individuals if the organization is a PSO) are enrolled for purposes of receiving health benefits from the organization and the organization primarily serves individuals residing outside of urbanized areas as defined in 42 CFR §412.62(f) (or, in the case of a PSO, the PSO meets the requirements at 42 CFR §422.352(c)). Except when an organization has a minimum enrollment waiver, the organization must maintain the minimum enrollment standards above for the duration of its contract.