US · guidance
CMS Pub. 100-16, ch. 10, § 20.1
General
Each Medicare Advantage (MA) organization must be licensed under State law as a risk-bearing entity. As provided in section 20 of chapter 1 of this manual, this means the
entity is licensed or otherwise authorized by the State to assume risk for offering health
insurance or health benefits coverage, such that the entity is authorized to accept prepaid
capitation for providing, arranging, or paying for comprehensive health services under an
MA contract.
For further discussion of MA State licensure requirements, refer to section 20.1 of
Chapter 11 of this manual (“MA Application Procedures and Contract Requirements”).
History
(Rev. 101, Issued: 08-19-11, Effective: 08-19-11, Implementation: 08-19-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7c3ae16a6319a98ee3156b6a43b3a4af8b15ef35f9b996c7f3d0471e1cae2a81
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