Written Information on Physician Participation

30 - Written Information on Physician Participation (Rev. 24, 06-06-03) An MA organization that operates a coordinated care plan or network Medical Saving Account (MSA) plan must provide for the participation of individual physicians and the management and members of groups of physicians, through reasonable procedures that include: 1. Written notice of rules of participation including terms of payment, credentialing, and other rules directly related to participation decisions; 2. Written notice of material changes in participation rules before the changes are put into effect; and 3. Written notice of adverse participation decisions and a process for appeal (see §60.4). An MA organization that operates an MA plan through subcontracted physician groups must provide that these participation procedures apply equally to physicians within those subcontracted groups. (Source: 42 CFR 422.202(a) and (c))