Common use of BENEFICIARY FINANCIAL PROTECTIONS Clause in Contracts

BENEFICIARY FINANCIAL PROTECTIONS. The MA Organization agrees to comply with the following requirements: (a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. To meet this requirement the MA Organization must-- (i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and (ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's beneficiary enrollees. [422.504(g)(1)] (b) The MA Organization must provide for continuation of enrollee health care benefits- (i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and (ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's insolvency, through the date of discharge. [422.504(g)(2)] (c) In meeting the requirements of this section (C), other than the provider contract requirements specified in paragraph (C)(3)(a) of this Article, the MA Organization may use~ (i) Contractual arrangements; (ii) Insurance acceptable to CMS; (iii) Financial reserves acceptable to CMS; or (iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]

BENEFICIARY FINANCIAL PROTECTIONS. The MA Organization agrees to comply with the following requirements: (a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. To meet this requirement the MA Organization must-- (i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and (ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's beneficiary enrollees. [422.504(g)(1)] (b) The MA Organization must provide for continuation of enrollee health care benefits- (i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and (ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's insolvency, through the date of discharge. [422.504(g)(2)] (c) In meeting the requirements of this section (C), other than the provider contract requirements specified in paragraph (C)(3)(a) of this Article, the MA Organization may use~ use-- (i) Contractual arrangements; ; (ii) Insurance acceptable to CMS; ; (iii) Financial reserves acceptable to CMS; or or (iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]

BENEFICIARY FINANCIAL PROTECTIONS. The MA Organization agrees to comply with the following requirements: (a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. To meet this requirement the MA Organization must--must— (i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's ’s providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and (ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's ’s beneficiary enrollees. [422.504(g)(1)] (b) The MA Organization must provide for continuation of enrollee health care benefits-benefits— (i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and (ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's ’s insolvency, through the date of discharge. [422.504(g)(2)]] Final August 21, 2009 (c) In meeting the requirements of this section (C), other than the provider contract requirements specified in paragraph (C)(3)(a) of this Article, the MA Organization may use~ use— (i) Contractual arrangements; ; (ii) Insurance acceptable to CMS; ; (iii) Financial reserves acceptable to CMS; or or (iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]

BENEFICIARY FINANCIAL PROTECTIONS. The MA Organization agrees to comply with the following requirements: (a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. To meet this requirement the MA Organization must--must— (i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and (ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's beneficiary enrollees. [422.504(g)(1)]] Final: August 25,2009 (b) The MA Organization must provide for continuation of enrollee health care benefits- (i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and (ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's insolvency, through the date of discharge. [422.504(g)(2)] (c) In meeting the requirements of this section (C), other than the provider contract requirements specified in paragraph (C)(3)(a) of this Article, the MA Organization may use~ use-- (i) Contractual arrangements; ; (ii) Insurance acceptable to CMS; ; (iii) Financial reserves acceptable to CMS; or or (iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]

BENEFICIARY FINANCIAL PROTECTIONS. The MA Organization agrees to comply with the following requirements: (a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. To meet this requirement the MA Organization must--must— (i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's ’s providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and (ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's ’s beneficiary enrollees. [422.504(g)(1)] (b) The MA Organization must provide for continuation of enrollee health care benefits- (i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and (ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's ’s insolvency, through the date of discharge. [422.504(g)(2)] (c) In meeting the requirements of this section (C), other than the provider contract requirements specified in paragraph (C)(3)(a) of this Article, the MA Organization may use~ use — (i) Contractual arrangements; ; (ii) Insurance acceptable to CMS; ; (iii) Financial reserves acceptable to CMS; or or (iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]

BENEFICIARY FINANCIAL PROTECTIONS. The MA Organization agrees to comply with the following requirements: (a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. To meet this requirement the MA Organization must--must: (i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's ’s providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and (ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's ’s beneficiary enrollees. [422.504(g)(1)] (b) The MA Organization must provide for continuation of enrollee health care benefits-benefits: (i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and (ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's ’s insolvency, through the date of discharge. [422.504(g)(2)]] Final: August 25, 2009 (c) In meeting the requirements of this section (C), other than the provider contract requirements specified in paragraph (C)(3)(a) of this Article, the MA Organization may use~ use: (i) Contractual arrangements; ; (ii) Insurance acceptable to CMS; ; (iii) Financial reserves acceptable to CMS; or or (iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]

BENEFICIARY FINANCIAL PROTECTIONS. The MA Organization agrees to comply with the following requirements: (a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. To meet this requirement the MA Organization must--must— (i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's ’s providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and (ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's ’s beneficiary enrollees. [422.504(g)(1)] (b) The MA Organization must provide for continuation of enrollee health care benefits- (i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and (ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's ’s insolvency, through the date of discharge. [422.504(g)(2)] (c) In meeting the requirements of this section (C), other than the provider contract requirements specified in paragraph (C)(3)(a) of this Article, the MA Organization may use~ use— (i) Contractual arrangements; ; (ii) Insurance acceptable to CMS; ; (iii) Financial reserves acceptable to CMS; or or (iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]

BENEFICIARY FINANCIAL PROTECTIONS. The MA Organization agrees to comply with the following requirements: (a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. , To meet this requirement the MA Organization must--must— (i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's ’s providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and (ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's ’s beneficiary enrollees. [422.504(g)(1)] (b) The MA Organization must provide for continuation of enrollee health care benefits- (i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and (ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's ’s insolvency, through the date of discharge. [422.504(g)(2)] (c) In meeting the requirements of this section (C), other than the provider contract requirements specified in paragraph (C)(3)(a) of this Article, the MA Organization may use~ use— (i) Contractual arrangements; ; (ii) Insurance acceptable to CMS; ; (iii) Financial reserves acceptable to CMS; or or (iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]