42 CFR §422.113(b)

May 23, 2020 3:27 pm Published by

(2) MA organization financial responsibility. The MA organization is financially responsible for emergency and urgently needed services—

(i) Regardless of whether the services are obtained within or outside the MA organization;

(ii) Regardless of whether there is prior authorization for the services.

(3) Stabilized condition. The physician treating the enrollee must decide when the enrollee may be considered

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