42 C.F.R. § 405.455 Application to Medicare+Choice contracts.
Title 42 - Public Health
An organization that has a contract with CMS to provide one or more Medicare+Choice (M+C) plans to beneficiaries (part 422 of this chapter): (a) Must acquire and maintain information from Medicare carriers on physicians and practitioners who have opted-out of Medicare. (b) Must make no payment directly or indirectly for Medicare covered services furnished to a Medicare beneficiary by a physician or practitioner who has opted-out of Medicare. (c) May make payment to a physician or practitioner who furnishes emergency or urgent care services to a beneficiary who has not previously entered into a private contract with the physician or practitioner in accordance with §405.440.
Title 42: Public Health
PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED
Subpart D—Private Contracts
§ 405.455 Application to Medicare+Choice contracts.
