42 C.F.R. § 417.423

Current through September 30, 2024
Section 417.423 - Special rules: ESRD and hospice patients
(a)ESRD patients.
(1) A Medicare beneficiary who has been medically determined to have end-stage renal disease is not eligible to enroll in an HMO or CMP.
(2) However, if a beneficiary is already enrolled in an HMO or CMP when he or she is determined to have end-stage renal disease, the HMO or CMP-
(i) Must reenroll the beneficiary as required by § 417.434 ; and
(ii) May not disenroll the beneficiary except as provided in § 417.460 .
(b)Hospice patients. A Medicare beneficiary who elects hospice care under § 418.24 of this chapter is not eligible to enroll in an HMO or CMP as long as the hospice election remains in effect.

42 C.F.R. §417.423

60 FR 45677, Sept. 1, 1995