US · guidance
CMS Pub. 100-16, ch. 8, § 10
General Payment Rules
CMS makes advance monthly payments to an MA organization for each enrollee in an MA
plan for coverage of original Medicare benefits in an MA payment area for a month.
In the case of an enrollee in an MA-PD plan, the MA organization also receives payment
for coverage of Part D prescription drug benefits, including: direct and reinsurance subsidy
payments for qualified prescription drug coverage, and reimbursement for the beneficiary
drug premium, and the cost sharing reductions applicable to low-income individuals
enrolled in the plan.
History
(Rev. 89; Issued: 11-02-07; Effective/Implementation: 11-02-07)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
2bab1855748e2970b1432b501b40825a97e2ad9fe9abbbf5e0a815248d34f613
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