Medicare Managed Care Manual (Pub. 100-16), Ch. 16a § 160.5

Partial Network PFFS Plan Transitioning to a Full Network

Last amended: 2011Year: 2011Length: 137 wordsOfficial source
160.5 - Partial Network PFFS Plan Transitioning to a Full Network PFFS Plan (Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11) An MA organization with a PFFS partial network contract may consolidate one or more current partial network PFFS PBPs into a new or renewal full network PFFS PBP under a separate contract held by the same legal entity. Current members of a PFFS partial network plan or plans being consolidated into a new or renewal PFFS full network plan will not be required to take any enrollment action, and the organization will not submit enrollment transactions to MARx for those current members. New members must complete enrollment requests, and the MA organization will submit enrollment transactions to MARx for those new members. Current members of the consolidated PFFS full network plan must receive a standard ANOC.
Medicare Managed Care Manual (Pub. 100-16), Ch. 16a § 160.5: Partial Network PFFS Plan Transitioning to a Full Network | Justis AI