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The BBA of 1997 Specifies the Ways in Which a Medicare+Choice

Question 150

Multiple Choice

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

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