Medicare Managed Care Manual (Pub. 100-16), Ch. 16a § 50.5
Availability of the Terms and Conditions of Payment
50.5 - Availability of the Terms and Conditions of Payment
(Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11)
PFFS plans are required to make their terms and conditions of payment easily accessible
to providers in the United States. CMS considers a provider to have reasonable access to
a plan’s terms and conditions of payment if the plan makes this information easily
accessible through the postal service, electronic mail, fax, telephone, or the plan’s
website. PFFS plans should post the terms and conditions of payment on their website in
a way that requires minimal navigation from the plan’s main webpage.