Medicare Managed Care Manual (Pub. 100-16), Ch. 4 § 20.5.3
End of Post-Stabilization
20.5.3 – End of Post-Stabilization
(Rev. 120, Issued: 01-16-15, Effective: 01-01-15, Implementation: 01-01-15)
The MAO’s financial responsibility for post-stabilization care services it has not pre-
approved ends when:
• A plan physician with privileges at the treating hospital assumes responsibility for the
enrollee’s care;
• A plan physician assumes responsibility for the enrollee’s care through transfer;
• An MAO representative and the treating physician reach an agreement concerning the
enrollee’s care; or
• The enrollee is discharged.