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US · guidance

CMS Pub. 100-16, ch. 11, § 100.6

Implementation of Written Policies With Respect to the Enrollee

activein force · 2026-08-25 – presentas-observed

Rights

(Rev. 79, Issued 02-17-06, Effective Date 02-17-06)

The organization must articulate enrollees' rights, promote the exercise of those rights,

ensure that its staff and affiliated providers are familiar with enrollee rights, and treat

enrollees accordingly. While most of the standards in this domain address basic

procedural protections for enrollees, they are closely related to quality of care.

Interpersonal aspects of care are highly important to most patients. Enrollees' interactions

with the organization and its providers can have an important bearing on their willingness

and ability to understand and comply with recommended treatments, and hence, on

outcomes and costs. Policies are communicated to enrollees in the enrollee statement

furnished in accordance with Chapter 2 of this manual, and to the organization's staff and

affiliated providers, at the time of initial employment or affiliation, and annually

thereafter.

Material on enrollee rights must be included in provider contracts or provider manuals,

and in staff handbooks or other training materials.

History

(Rev. 79, Issued 02-17-06, Effective Date 02-17-06)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
7add300179cc9c57ceb5b793afe381d017db1f5ff0aaa5e3f33ab0520c158275
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