Medicare Managed Care Manual (Pub. 100-16), Ch. 17b § 170
Initial Enrollment
170 - Initial Enrollment
(Rev. 4, 10-01-01)
Cost-based HMO/CMPs, which offer Medicare benefits for the first time, are likely to
incur relatively higher marketing and enrollment costs in offering their HMO/CMPs to
Medicare beneficiaries. In determining whether these higher costs are reasonable, CMS
may allow them if they do not exceed what prudent and cost conscious management
would incur.