US · guidance
CMS Pub. 100-16, ch. 8, § 80
Adjustment of Payments to Reflect the Number of Medicare
Enrollees
(Rev. 89; Issued: 11-02-07; Effective/Implementation: 11-02-07)
Per 42 CFR 422.308(f), CMS makes retroactive adjustments to the aggregate monthly
payments to take into account any difference between the actual number of Medicare
enrollees in a plan, and the number on which CMS had based the organization’s advance
monthly payment.
CMS applies payment rates and adjustment factors applicable to the month of enrollment.
Monthly payments to MA organizations reflect all beneficiaries with an effective
enrollment in the MA plan in question for the month for which payment is made, including
those whose enrollment was effective prior to that month, and those for whom enrollment
is effective as of that month.
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
9fc532e63b22196b21a8dc1d1c7fb1d0735ed818d9256af0c5a057308a3cd361
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