医疗保险计划；医疗保险优势和处方药福利计划。最终规则。

Medicare program; Medicare Advantage and prescription drug benefit programs. Final rule.

出版信息

Fed Regist. 2011 Sep 1;76(170):54600-35.

Abstract

This final rule finalizes revisions to the regulations governing the Medicare Advantage (MA) program (Part C), prescription drug benefit program (Part D) and section 1876 cost plans including conforming changes to the MA regulations to implement statutory requirements regarding special needs plans (SNPs), private fee-for-service plans (PFFS), regional preferred provider organizations (RPPO) plans, and Medicare medical savings accounts (MSA) plans, cost-sharing for dual-eligible enrollees in the MA program and prescription drug pricing, coverage, and payment processes in the Part D program, and requirements governing the marketing of Part C and Part D plans.

摘要

本最终规则确定了对医疗保险优势（MA）计划（C部分）、处方药福利计划（D部分）以及第1876条成本计划相关法规的修订，包括对MA法规进行相应修改，以实施关于特殊需求计划（SNP）、私人服务收费计划（PFFS）、区域优先提供者组织（RPPO）计划和医疗保险医疗储蓄账户（MSA）计划的法定要求，MA计划中双重资格参保人的费用分摊，以及D部分计划中的处方药定价、覆盖范围和支付流程，还有关于C部分和D部分计划营销的要求。

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