Medicare Managed Care Manual (Pub. 100-16), Ch. 16a § 70
PFFS Payment Rules for Providers and Cost Sharing Rules for
70 – PFFS Payment Rules for Providers and Cost Sharing Rules for
Members
(Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11)
42 CFR 422.114 and 422.216