US · guidance
CMS Pub. 100-16, ch. mc86c16a, § 70.2.1
General Rules
• The plan must meet the access to services requirement by paying all providers at
least the Original Medicare rates or higher for all categories of Part A and Part B
services.
• The plan must operate using deemed providers for all categories of Part A and
Part B services, if the deeming conditions described in 42 CFR 422.216(f) and
section 40.2 of this chapter are met.
• The plan may have some direct-contracting providers. The plan may establish
signed contracts or agreements with some providers without meeting the access
standards described in section 1852(d)(1) of the Act and section 30.2 of this
chapter.
History
(Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
c5c4fbf80494f4e57ca851af43d8b385fca9bab18bbcd7abc959ed4c03692351
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