Identifying alternate providers when terminating from the network

When a provider terminates from a Medicare Advantage Organization’s network, the Centers for Medicare & Medicaid Services (CMS) now requires that the organization share a list of alternate in-network providers with members who were receiving treatment from the terminating provider to ensure continued care.

As a reminder, provider terminations must be submitted to CarePartners of Connecticut with advance notice per contractual terms and policies. Upon submitting a provider termination notice to CarePartners of Connecticut, please identify two alternate providers within the practice who are available to members. Include the following information in the provider termination request:

• Alternate provider names
• Alternate provider NPIs
• Alternate provider phone numbers

If no alternate providers are available within the practice, please work with your physician organization to identify the alternates. CarePartners of Connecticut will select alternate providers to share with the member if none are included in the termination notice.