Medicare Managed Care Manual (Pub. 100-16), Ch. 9 § 60.1
State Licensure
Length: 87 wordsOfficial source
60.1 - State Licensure
(Rev. 111, 05-03-13, Effective: 05-03-13, Implementation: 05-03-13)
In general, an MAO must be organized and licensed under State law as a risk-bearing entity
eligible to offer health insurance or health benefits coverage in each State in which it offers
coverage. However, an employer/union applying to become an MAO solely for purposes of
providing coverage to its members will not have to meet the State licensing requirements set
forth at 42 CFR 422.400(a) and 42 CFR 422.503(b)(2) as a condition of being an MAO.