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医疗保险计划;提供者赞助组织的豁免要求和偿付能力标准——医疗保健财务管理局。有意见征求期的暂行最终规则。

Medicare program; waiver requirements and solvency standards for provider-sponsored organizations--HCFA. Interim final rule with comment period.

出版信息

Fed Regist. 1998 May 7;63(88):25360-79.

PMID:10179330
Abstract

This interim final rule with a request for comments implements authority to waive, in the case of provider-sponsored organizations (PSOs) that meet certain criteria, the requirement that Medicare + Choice organizations be licensed by a State as risk-bearing entities. The waivers will be approved only under certain conditions where the State has denied or failed to act on an application for licensure. This rule also establishes solvency standards that certain entities must meet to contract as PSOs under the new Medicare + Choice program. These standards apply to PSOs that have received a waiver of the requirement that Medicare + Choice organizations be licensed by a State as risk-bearing entities.

摘要

本带有征求意见请求的暂行最终规则实施了一项权力,即在符合某些标准的提供者赞助组织(PSO)的情况下,免除医疗保险+选择计划组织作为承担风险实体须获得州许可的要求。只有在州拒绝或未对许可申请采取行动的特定条件下,豁免才会被批准。本规则还确立了某些实体根据新的医疗保险+选择计划作为PSO签约时必须满足的偿付能力标准。这些标准适用于已获得免除医疗保险+选择计划组织作为承担风险实体须获得州许可这一要求的PSO。

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