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CMS Medicare Internet-Only Manuals
100-16
CMS Pub. 100-16
Medicare Managed Care Manual
Centers for Medicare & Medicaid Services
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1 (Rev. 125)
General Provisions
3
Marketing Guides Instructions
4 (Rev. 121)
Benefits and Beneficiary Protections
5 (Rev. 117)
Quality Assessment
6 (Rev. 82)
Relationships With Providers
7 (Rev. 118)
Risk Adjustment
8 (Rev. 118)
Payments to Medicare Advantage Organizations
9 (Rev. 111)
Employer/Union Sponsored Group Health Plans
10 (Rev. 103)
MA Organization Compliance with State Law and Preemption by Federal Law
11 (Rev. 83)
Medicare Advantage Application Procedures and Contract Requirements
12 (Rev. 113)
Effect of Change of Ownership
13
Medicare Managed Care Beneficiary Grievances, Organization Determinations, and Appeals Applicable to Medicare Advantage Plans, Cost Plans, and Health Care Prepayment Plans (HCPPs), (collectively referred to as Medicare Health Plans)
14 (Rev. 122)
Contract Determinations and Appeals
15 (Rev. 73)
Intermediate Sanctions
16A (Rev. 99)
Subchapter A - Private Fee-for-Service (PFFS) Plans
16B (Rev. 131)
Subchapter B - Special Needs Plans
17A
Subchapter A - TEFRA Cost Based Payment Processes and Principles
17B (Rev. 86)
Subchapter B - Payment Principles for Cost-Based HMOs and CMPs
17C (Rev. 4)
Subchapter C - Cost Apportionment for Cost-Based HMOs and CMPs
17D (Rev. 38)
Subchapter D - Medicare Cost Plan Enrollment and Disenrollment Instructions
17F (Rev. 77)
Subchapter F - Benefits and Beneficiary Protections
18A
Subchapter A - Cost-Based Payment Process and Principles
18B (Rev. 85)
Subchapter B - Payment Principles for Cost-Based HMOs and CMPs
18C (Rev. 30)
Subchapter C - Cost Apportionment for Cost-Based HMO/CMPs
21
Compliance Program Guidelines and Prescription Drug Benefit Manual Chapter 9 - Compliance Program Guidelines