Medicare Managed Care Manual (Pub. 100-16), Ch. 18c § 20

HCPP Services Furnished Nonenrolled Medicare Patients

Last amended: 2003Year: 2003Length: 92 wordsOfficial source
20 - HCPP Services Furnished Nonenrolled Medicare Patients (Rev. 30, 09-05-03) The HCPP may furnish services to Medicare beneficiaries who are not enrolled in the HCPP's prepayment plan. Since the agreement with CMS is limited to Medicare beneficiaries actually enrolled in the HCPP, the cost apportionment process distinguishes between Medicare enrollees of the HCPP and nonenrolled Medicare patients. For services furnished Medicare patients not enrolled in the HCPP, Medicare payment is made through the Part A intermediary or Part B carrier, outside the scope of the cost- based HCPP agreement with CMS.
Medicare Managed Care Manual (Pub. 100-16), Ch. 18c § 20: HCPP Services Furnished Nonenrolled Medicare Patients | Justis AI