CMS Pub. 100-16, ch. mc86c16a, § 160.6

a Full Network PFFS Plan

(Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11)

An MA organization with a PFFS partial network contract may consolidate some

counties in the service area of a current partial network PFFS PBP into a single new or

renewal full network PFFS PBP under a separate contract held by the same legal entity.

Current members in the remaining counties in the current year’s partial network PFFS

PBP may remain in the subsequent year’s partial network PBP provided the MA

organization follows the rules for a renewal plan with a SAR described in section 140.6

of Chapter 4 of this manual.

The MA organization must submit enrollment transactions to MARx for current members

in the counties affected by the SAR who will be transitioned to a new or renewing full

network PBP under a separate contract held by the same legal entity. New members must

complete enrollment requests, and the MA organization will submit enrollment

transactions to MARx for those new members. Current members transitioned to the

PFFS full network plan must receive a standard ANOC.