Cost Sharing Rules for Members

70.2.4 - Cost Sharing Rules for Members (Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11) The plan cannot vary a member’s actual out-of-pocket costs (regardless of whether copayment or coinsurance applies) with respect to a particular category of Part A or Part B service, regardless of whether the provider is a deemed or direct-contracting provider.