Identification Number:
HI 00801 TN 38
Intended Audience:See Transmittal Sheet
Originating Office:Centers for Medicare & Medicaid Services (CMS)
Title:Hospital Insurance Entitlement
Type:POMS Transmittals
Program:
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part HI – Health Insurance
Chapter 008 – Requirement for Entitlement and Termination
Subchapter 01 – Hospital Insurance Entitlement
Transmittal No. 38, 10/29/2020

Audience

PSC: BA, CA, CS, DS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, CR, CTE, EIE, ERE, FCR, FDE, PETL, RECONE, RECONR;
OCO-ODO: BET, BTE, CCE, CR, CST, CTE, CTE TE, DEC, PAS, PETE, PETL;
FO/TSC: CS, CS TII, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

CMS

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal and the edits will not introduce new policy or procedure.

Summary of Changes

HI 00801.143 Evidence of Enrollment in A Medicare Managed Care Plan

We are updating the email address and telephone number.

HI 00801.143 Evidence of Enrollment in A Medicare Managed Care Plan

A. Policy

In all cases of enrollment or premium surcharge relief under the transfer enrollment period provisions, it is necessary to verify that the individual is or was enrolled in an MMCP that meets the requirements in HI 00208.066C.2. and HI 00208.066.D.

B. Procedure

Enrollment in an MMCP can be verified by checking the Medicare Enrollment Query (MEQY) on the HI/SMI Query Response (HIQR) Screen (see MSOM QUERIES 008.001). The dates of enrollment and disenrollment can also be obtained from the MEQY. If termination information is not shown, assume that the individual is still enrolled in the MMCP.

If there is no enrollment information on the MEQY or a discrepancy in the dates shown, contact the appropriate CMS Regional Office (see HI 00801.143C.) for assistance in obtaining the necessary evidence.

C. CMS Regional offices

Region I (Boston)

 

(617) 565-1267
roboshpp@cms.hhs.gov

 

Region IV (Atlanta)

(404) 562-7360

roatlhpp@cms.hhs.gov

 

Region VII (Kansas City)

(816) 426-5783

rokcmmo@cms.hhs.gov

 

Region X (Seattle)

 

(206) 615-2351

roseammcb@cms.hhs.gov

 

Region II (New York)

(212) 264-3657
ronyhps@cms.hhs.gov

 

Region V (Chicago)

(312) 353-5737 rochiora@cms.hhs.gov

Region VIII (Denver)

(303) 844-1568

rodenpub@cms.hhs.gov

 

Region III (Philadelphia)


(215) 861-4226

PartDComplaints_RO3@cms.hhs.gov

Region VI (Dallas)

(214) 767-6401 rodalora@cms.hhs.gov

Region IX (San Francisco)

(415) 744-3617 rosfohpp@cms.hhs.gov

 

 


HI 00801 TN 38 - Hospital Insurance Entitlement - 10/29/2020