An agreement between an HMO and CMS to provide services to Medicare beneficiaries under which the health plan receives a monthly payment for enrolled Medicare members and must then provide all services needed is called a(n) ____________________________.

Question

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A risk contract is an agreement where the HMO receives a fixed monthly payment per enrolled member from CMS and is responsible for providing all necessary services, bearing the financial risk if costs exceed the payments.

An Agreement Between an HMO and CMS to Provide Services