Crosswalk - Network Adequacy Guidance

Crosswalk - Network Adequacy Guidance (CMS-4192-P version 4).pdf

Triennial Network Adequacy Review for Medicare Advantage Organizations and 1876 Cost Plans (CMS-10636)

Crosswalk - Network Adequacy Guidance

OMB: 0938-1346

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Information Collection Guidance: MA
Network Adequacy Guidance

Change

Includes language regarding proposed changes around initial applicant netwo Introduction

CMS-4192-P proposed revisions at 42 C.F.R. § 422.116 which would establish the requirement that
applicants for a new or expanding service area must demonstrate compliance with network adequacy
standards as part of an MA application and that CMS may deny an application on the basis of an
evaluation of the applicant's network.

Information Collection Guidance: MA
Network Adequacy Guidance

Includes language regarding proposed network credits for new applicants

CMS-4192-P proposes that an applicant for a new or expanding service area will receive a 10 percentage
point credit towards the percentage of beneficiaries residing within published time and distance standards for
the contracted network in the pending service area, at the time of application and for the duration of the
application review

Current Location

New or Expanding Service Area Appliant Credit

Reason


File Typeapplication/pdf
AuthorAmber Casserly
File Modified2022-01-12
File Created2022-01-12

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