tci Medicare Compliance & Reimbursement - 2003 Issue 33

Managed Care: PENALTIES INCREASE FOR M+COs

M+C reg has good news and bad.A health plan's cost for terminating a Medi-care+Choice contract mid year just got steeper. The Centers for Medicare & Medicaid Services has jacked up the civil monetary penalty for such terminations to either $250 per enrolled Medicare member or $100,000, whichever is greater. The cap used to be only $25,000. The provision is one of many in CMS' Aug. 22 managed care final rule, which implements a number of provisions of the Benefits Improvement and Protection Act of 2000. On the plus side for plans, the rule forbids CMS from...

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