Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 40.21
Informing Medicare Managed Care Plans of the Identity of the Opt-Out
40.21 - Informing Medicare Managed Care Plans of the Identity of the Opt-Out
Physicians or Practitioners
(Rev. 222, Issued: 05-13-16, Effective: 08-15-16, Implementation; 08-15-16)
The Medicare contractor must develop data exchange mechanisms for furnishing Medicare managed care
plans in its service area with timely information on physicians and practitioners who have opted out of
Medicare. For example, it may wish to establish an Internet website “Home Page” which houses all of the
information on physicians or practitioners who have opted out. It will need to negotiate appropriate opt-out
information exchange mechanisms with each managed care plan in its service area.