US · guidance
CMS Pub. 100-16, ch. 6, § 90
Provider Indemnification of MA Organization Prohibited
An MA organization may not contract or otherwise provide, directly or indirectly, for any
of the following individuals, organizations, or entities to indemnify the MA organization
against any civil liability for damage caused to an enrollee as a result of the MA
organization’s denial of medically necessary care:
1. A physician or health care professional;
2. Provider of services;
3. Other entity providing health care services; and
4. A Group of such professionals, providers, or entities.
(Source: 42 CFR 422.212.)
History
(Rev. 24, 06-06-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
6ba81d590c9051e1760bb7663a6ffe0c3a7b11741646be6a2387aa375c679079
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