Medicare Managed Care Manual (Pub. 100-16), Ch. 4 § 20.5.4
Cost-Sharing
20.5.4 – Cost-Sharing
(Rev. 120, Issued: 01-16-15, Effective: 01-01-15, Implementation: 01-01-15)
Enrollee charges for post-stabilization care services may not be greater than what the
organization would charge the enrollee if s/he had obtained the services through a
contracted provider of the MAO. For purposes of cost-sharing, post-stabilization care
services begin when the patient is stabilized and the emergency ends.