[Code of Federal Regulations]
[Title 42, Volume 2]
[Revised as of October 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 42CFR422.102]

[Page 848]
 
                         TITLE 42--PUBLIC HEALTH
 
                             HUMAN SERVICES
 
PART 422--MEDICARE+CHOICE PROGRAM--Table of Contents
 
             Subpart C--Benefits and Beneficiary Protections
 
Sec. 422.102  Supplemental benefits.

    (a) Mandatory supplemental benefits. (1) Subject to CMS's approval, 
an M+C organization may require Medicare enrollees of an M+C plan other 
than an MSA plan to accept and pay for services in addition to Medicare-
covered services described in Sec. 422.101 and additional benefits 
described in Sec. 422.312.
    (2) If the M+C organization imposes mandatory supplemental benefits, 
it must impose them on all Medicare beneficiaries enrolled in the M+C 
plan.
    (3) CMS approves mandatory supplemental benefits if the benefits are 
designed in accordance with CMS's guidelines and requirements as stated 
in this part and instructions and operational policy letters.
    (b) Optional supplemental benefits. Except as provided in 
Sec. 422.104 in the case of MSA plans, each M+C organization may offer 
(for election by the enrollee and without regard to health status) 
services that are not included in the basic benefits as described in 
Sec. 422.100(c) and any mandatory supplemental benefits described in 
paragraph (a) of this section. Optional supplemental benefits are 
purchased at the discretion of the enrollee and must be offered to all 
Medicare beneficiaries enrolled in the M+C plan.
    (c) Payment for supplemental services. All supplemental benefits are 
paid for in full, directly by (or on behalf of) the enrollee of the M+C 
plan.
    (d) Marketing of supplemental benefits. M+C organizations may offer 
enrollees a group of services as one optional supplemental benefit, 
offer services individually, or offer a combination of groups and 
individual services.

[65 FR 40320, June 29, 2000]