The BBA of 1997 specifies the ways in which a Medicare+Choice plan can establish and use provider networks. A Medicare+Choice plan that operates as a private fee for service (PFFS) plan is allowed to
A) limit the size of its network to the number of providers necessary to meet the needs of its enrollees
B) require providers to accept as payment in full an amount no greater than 115% of the Medicare payment rate
C) refuse payment to non-network providers who submit claims for Medicare-covered expenses
D) shift all risk for Medicare-covered services to network providers
Correct Answer:
Verified
Q145: In most health plan pharmacy networks, the
Q146: The Medea Clinic is a network provider
Q147: The following statements are about managed dental
Q148: The provider contract between the Regal Health
Q149: The Ionic Group, a provider group with
Q151: Health plans often negotiate compensation arrangements that
Q152: The Octagon Health Plan includes a typical
Q153: The Tax Equity and Fiscal Responsibility Act
Q154: Promise, Inc., a corporation that specializes in
Q155: A provider contract describes the responsibilities of
Unlock this Answer For Free Now!
View this answer and more for free by performing one of the following actions
Scan the QR code to install the App and get 2 free unlocks
Unlock quizzes for free by uploading documents