405.455—Application to Medicare Choice contracts.

An organization that has a contract with CMS to provide one or more Medicare Choice (M C) plans to beneficiaries ( part 422 of this chapter ):

(a) Must acquire and maintain information from Medicare carriers on physicians and practitioners who have opted-out of Medicare.

(b) Must make no payment directly or indirectly for Medicare covered services furnished to a Medicare beneficiary by a physician or practitioner who has opted-out of Medicare.

(c) May make payment to a physician or practitioner who furnishes emergency or urgent care services to a beneficiary who has not previously entered into a private contract with the physician or practitioner in accordance with § 405.440.

CFR

405.455—Application to Medicare Choice contracts.