Medicare Managed Care Manual (Pub. 100-16), Ch. 16a § 160.5
Partial Network PFFS Plan Transitioning to a Full Network
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.