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US · guidance

CMS Pub. 100-18, ch. 12, § 20.16.1

Governmental Entities

activein force · 2026-09-17 – presentas-observed

In general, in accordance with section 1860D-41(a)(13) of the Act, governmental entities are

not permitted to be PDP sponsors. However, CMS waived this prohibition for governmental

entities, such as for state retirement funds and municipal or local government plans, applying

to sponsor a Direct Contract EGWP for their retirees.

History

(Rev.6, Issued: 11-07-08, Effective/Implementation: 11-07-08)

Provenance

Source
cms.gov
Retrieved
2026-09-17
Edition
iom-2026-09-17
Content hash
e9d0458633f2a1caea9e0f61bea8ea2513b8d5e0be508a6c6324055081d2ae29
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