As an authorized Medicare+Choice plan, the Brightwell HMO must satisfy CMS requirements regulating access to covered services. In order to ensure that its network provides adequate access, Brightwell must

Question

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Brightwell must define its service area based on community patterns of care to ensure that its network provides adequate access to covered services. This ensures that enrollees have access to needed services within a reasonable distance from their residence. Allowing enrollees to determine their primary care provider (choice A) and basing a provider's participation and reimbursement on their license or certification (choice B) are not related to ensuring adequate access to covered services. Requiring prior authorization for emergency or urgently needed services (choice D) could potentially delay necessary care and is not a suitable way to ensure access.

As an Authorized Medicare+Choice Plan, the Brightwell HMO Must Satisfy