CMS Pub. 100-16, ch. 4, § 180.4

The written information provided to enrollees must, at a minimum, include a description

of the MAO’s written policies on advance directives, including an explanation of the

following:

• That the MAO cannot refuse care or otherwise discriminate against an individual

based on whether or not the individual has executed an advance directive;

• The right to file a complaint about an MAO’s noncompliance with advance directive

requirements, and where to file the complaint;

• That the plan must document in a prominent part of the individual’s current medical

record whether or not the individual has executed an advance directive;

• That the MAO is required to comply with state law (See section 180.3 for details);

• That the MAO must educate its staff about its policies and procedures for advance

directives; and

• That the MAO must provide for community education regarding advance directives.

If the MAO cannot implement an advance directive as a matter of conscience, it must

issue a clear and precise written statement of this limitation. The statement must include

information that:

• Explains the differences between institution-wide objections based on conscience and

those that may be raised by individual physicians;

• Identifies the state legal authority permitting such objection; and

• Describes the range of medical conditions or procedures affected by the conscience

objection.