Medicare Advantage Health Plan Module , Version 3.0 MA MRG CN07: REQUIRED CONTRACT PROVISIONS FOR DEEMABLE ACTIVITIES:DELEGATION


The Basics

This CMS standard provides:

The MAO’s written contracts with any entity that performs deemable activities that are delegated under its contract with CMS, must contain provisions that specify that the entity adhere to the delegation requirements in the MA regulation.  

This standard is fully implemented by the standards dealing with delegation agreements.  

URAC Accreditation Tips

The only documentation needed at the desktop stage is a sample a delegation agreement.

The on-site interview of personnel in charge of delegation oversight will ask:

 

  • "What are the general terms of the delegate agreement? 
  • How do you monitor compliance with CMS regulations?"