Find out what rights you and your patients have under current federal statutes and regulations, such as the Employee Retirement Income Security Act and the Medicare Advantage program.
Essential community providers
Access to services under an MA private fee-for-service plan
Network adequacy standards
Internal claims and appeals and external review processes
How an MA organization must effectuate expedited reconsidered determinations
How an MA organization must effectuate standard reconsidered determinations or decisions.
Timeframes and responsibility for reconsiderations