Except as specified in §§ 417.423 and 417.424, an HMO or CMP must enroll, either for an indefinite period or for a specified period of at least 12 months, any individual who meets all of the following:
- (a) Is entitled to Medicare benefits under Parts A and B or under Part B only.
- (b) Lives within the geographic area served by the HMO or CMP.
- (c) Is not enrolled in any other HMO or CMP that has entered into a contract under subpart L of this part.
- (d) During an enrollment period of the HMO or CMP, completes the HMO's or CMP's application form or another CMS-approved election mechanism and gives whatever information is required for enrollment.
- (e) Agrees to abide by the HMO's or CMP's rules after they are disclosed to him or her in connection with the enrollment process.
- (f) Is not denied enrollment by the HMO or CMP under a selection policy, if any, that has been approved by CMS under § 417.424(b).
- (g) Is not denied enrollment by the HMO or CMP on the basis of any of the administrative criteria concerning denial of enrollment in § 417.424(a).
- (h) Is a United States citizen or an individual who is lawfully present in the United States as determined in 8 CFR 1.3.
[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38078, July 15, 1993; 60 FR 45677, Sept. 1, 1995; 77 FR 22166, Apr. 12, 2012; 80 FR 7958, Feb. 12, 2015]