[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: 42CFR422.110]

[Page 852]
 
                         TITLE 42--PUBLIC HEALTH
 
                             HUMAN SERVICES
 
PART 422--MEDICARE+CHOICE PROGRAM--Table of Contents
 
             Subpart C--Benefits and Beneficiary Protections
 
Sec. 422.110  Discrimination against beneficiaries prohibited.

    (a) General prohibition. Except as provided in paragraph (b) of this 
section, an M+C organization may not deny, limit, or condition the 
coverage or furnishing of benefits to individuals eligible to enroll in 
an M+C plan offered by the organization on the basis of any factor that 
is related to health status, including, but not limited to the 
following:
    (1) Medical condition, including mental as well as physical illness.
    (2) Claims experience.
    (3) Receipt of health care.
    (4) Medical history.
    (5) Genetic information.
    (6) Evidence of insurability, including conditions arising out of 
acts of domestic violence.
    (7) Disability.
    (b) Exception. An M+C organization may not enroll an individual who 
has been medically determined to have end-stage renal disease. However, 
an enrollee who develops end-stage renal disease while enrolled in a 
particular M+C organization may not be disenrolled for that reason. An 
individual who is an enrollee of a particular M+C organization, and 
resides in the M+C plan service area at the time he or she first becomes 
M+C eligible, is considered to be ``enrolled'' in the M+C organization 
for purposes of the preceding sentence.
    (c) Additional requirements. An M+C organization is required to 
observe the provisions of the Civil Rights Act, Age Discrimination Act, 
Rehabilitation Act of 1973, and Americans with Disabilities Act (see 
Sec. 422.502(h)).

[63 FR 35077, June 26, 1998; 63 FR 52612, Oct. 1, 1998; 64 FR 7980, Feb. 
17, 1999, as amended at 65 FR 40321, June 29, 2000]