US · guidance
CMS Pub. 100-16, ch. 9, § 30.3
Enrollment of End Stage Renal Disease (ESRD) Members
CMS has granted an additional waiver of 42 CFR 422.50(a) (2) to allow employer/union group
members who have ESRD to enroll in employer/union-sponsored MA plans, under certain
circumstances.
The MA organizations may choose to accept enrollees with ESRD who are enrolling in an MA
plan through an employer or union group under any one of four scenarios described in Medicare
Managed Care Manual Chapter 2 (Medicare Advantage). As a condition, the MA organizations
that choose to apply this waiver must agree to apply it consistently; MAOs must consistently
allow enrollment of employer/union group ESRD beneficiaries in all plan benefit packages
offered by the MAO under a particular MA contract. Each year, MA organizations may choose
whether or not to apply this waiver at the time of their renewal. For further information, refer to
Medicare Managed Care Manual, Chapter 2 (Medicare Advantage Enrollment and
Disenrollment), §20.2.3.
History
(Rev. 111, 05-03-13, Effective: 05-03-13, Implementation: 05-03-13)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
3439b98112fecd326e82aea232ff82c646a8f60877d20aab87256a5d2e1f612a
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