42 C.F.R. § 417.422 Eligibility to enroll in an HMO or CMP.
Title 42 - Public Health
Except as specified in §§417.423 and 417.424, an HMO or CMP must enroll, either for an indefinite period or for a specified period of at least 12 months, any individual who— (a) Is entitled to Medicare benefits under Parts A and B or under Part B only; (b) Lives within the geographic area served by the HMO or CMP; (c) Is not enrolled in any other HMO or CMP that has entered into a contract under subpart L of this part; (d) During an enrollment period of the HMO or CMP, completes and signs the HMO's or CMP's application form and gives whatever information is required for enrollment; (e) Agrees to abide by the HMO's or CMP's rules after they are disclosed to him or her in connection with the enrollment process; (f) Is not denied enrollment by the HMO or CMP under a selection policy, if any, that has been approved by CMS under §417.424(b); and (g) Is not denied enrollment by the HMO or CMP on the basis of any of the administrative criteria concerning denial of enrollment in §417.424(a). [50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38078, July 15, 1993; 60 FR 45677, Sept. 1, 1995]
Title 42: Public Health
PART 417—HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS
Subpart K—Enrollment, Entitlement, and Disenrollment under Medicare Contract
§ 417.422 Eligibility to enroll in an HMO or CMP.
