Medicare Managed Care Manual (Pub. 100-16), Ch. 17c § 100
Apportionment of Administrative and General Costs Not Directly
100 - Apportionment of Administrative and General Costs Not Directly
Associated With Providing Medical Care
(Rev. 4, 10-01-01)
Enrollment and marketing costs (as defined in Chapter 17, Subchapter B, section 160),
membership costs (as defined in Chapter 17, Subchapter B, section 180), as well as other
administrative and general costs of the HMO/CMP that benefit the total enrolled
population of the HMO/CMP which are not directly associated with providing medical
care, are apportioned on the basis of a ratio of Medicare enrollment to total HMO/CMP
enrollment. These costs are classified as Plan Administration costs. Examples of such
costs are:
•
Directors’ salaries and fees;
•
Executive and staff administrative salaries;
•
Organizational costs; and
•
Other costs of administering the plan.