Network-based plan defined
(i) In general
(i)In general#
For purposes of subparagraph (B), the term “network-based plan” means—
(I) except as provided in clause (ii), a Medicare Advantage plan that is a coordinated care plan described in section 1395w–21(a)(2)(A)(i) of this title ;
(II) a network-based MSA plan; and
(III) a reasonable cost reimbursement plan under section 1395mm of this title .
(i)(I)#
except as provided in clause (ii), a Medicare Advantage plan that is a coordinated care plan described in section 1395w–21(a)(2)(A)(i) of this title ;
(i)(II)#
a network-based MSA plan; and
(i)(III)#
a reasonable cost reimbursement plan under section 1395mm of this title .
(ii)Exclusion of non-network regional PPOS#
The term “network-based plan” shall not include an MA regional plan that, with respect to the area, meets access adequacy standards under this part substantially through the authority of section 422.112(a)(1)(ii) of title 42, Code of Federal Regulations, rather than through written contracts.