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Clarification to Guidance on Medicare-Medicaid Plan (MMP) Application of Deductibles and Cost-Sharing when Reimbursing Non-Contract Providers

Guidance for Medicare-Medicaid Plans 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.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 28, 2018

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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.