Medicare Managed Care Manual (Pub. 100-16), Ch. 18c § 50

Emergency and Urgently Needed Medical Services and Other

Last amended: 2003Year: 2003Length: 95 wordsOfficial source
50 - Emergency and Urgently Needed Medical Services and Other Covered Medical Services for which the HCPP Assumes Financial Responsibility (Rev. 30, 09-05-03) Payments for services to nonplan physicians and suppliers for purchased services, such as emergency or urgently needed care outside the HCPP or unusual specialty services not available within the HCPP, are apportioned to Medicare enrollees in accordance with the principles set forth in §40 of this chapter. In most cases, this will limit CMS' payment to the HCPP to what the FFS system would have paid for the service in that area.
Medicare Managed Care Manual (Pub. 100-16), Ch. 18c § 50: Emergency and Urgently Needed Medical Services and Other | Justis AI