Medicare-Medicaid Plan (MMP) Application of Deductibles and Cost-Sharing when Reimbursing Non-Contract Providers
Guidance for clarifying policy regarding Medicare-Medicaid Plans’ (MMPs’) reimbursement of non-network providers for Medicare-covered services during what would have been a deductible period under fee-for-service Medicare. In determining payments due to non-contract providers, MMPs should not apply Medicare Part A or Part B deductibles.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 05, 2017
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.