Medicare Program; Establishment of the Medicare Advantage Program; Interpretation
medicare · Centers for Medicare and Medicaid Services · Rule · Published 2005-03-21 · Effective 2005-03-22 · 70 FR 13401
Document
Document number
05-5591
Federal Register citation
70 FR 13401
CFR reference
42 CFR 417
Type
Rule
Action
Final rule; interpretation.
Category
medicare
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2005-03-21
Effective date
2005-03-22
HHS docket
CMS-4069-F2
Abstract
This final rule clarifies our interpretation of the meaning of "entity" in the final rule titled "Medicare Program; Establishment of the Medicare Advantage Program" published in the Federal Register on January 28, 2005 (70 FR 4588). Subsequent to the publication of the Medicare Advantage (MA) final rule on January 28, 2005, we have received inquiries from parties interested in offering an MA Regional Plan concerning whether they could jointly enter into a contract with us to offer a single MA Regional Plan in a multistate region. The participating health plans wish to contract with each other to create a single "joint enterprise." They have asked us whether such a joint enterprise could be considered an "entity" under sections 1859(a)(1) and 1855(a)(1) of the Social Security Act, for purposes of offering an MA Regional Plan. The MA final rule is scheduled to take effect on March 22, 2005. Our interpretation of the word "entity" that follows in the "Supplementary Information" section of this final rule is deemed to be included in that final rule.