42 C.F.R. § 417.423
Special rules: ESRD and hospice patients.
Cite as 42 C.F.R. § 417.423 (2026)
(a)
ESRD patients.
(1) A Medicare beneficiary who has been medically determined to have end-stage renal disease is not eligible to enroll in an HMO or CMP.
(2) However, if a beneficiary is already enrolled in an HMO or CMP when he or she is determined to have end-stage renal disease, the HMO or CMP—
(i) Must reenroll the beneficiary as required by § 417.434; and
(ii) May not disenroll the beneficiary except as provided in § 417.460.
(b)
Hospice patients.
A Medicare beneficiary who elects hospice care under § 418.24 of this chapter is not eligible to enroll in an HMO or CMP as long as the hospice election remains in effect.
[60 FR 45677, Sept. 1, 1995]
- Cross-references to the CFR
- 417.434417.460.418.24