19. HMO INDICATOR CHAR 1 110 110 CODE INDICATING BENEFICIARY HAS MEMBERSHIP

IN HEALTH MAINTENANCE ORGANIZATION.

OCCURS: 12 TIMES

CODES:

EFFECTIVE 1992

0 = NOT A MEMBER OF HMO

1 = NON LOCK-IN, CMS TO PROCESS PROVIDER CLAIMS,COST-TYPE CONTRACT 2 = NON LOCK-IN, HMO TO PROCESS IN-PLAN PART A AND IN-AREA PART B CLAIMS,COST-TYPE CONTRACT

4 = CHRONIC CARE DISEASE MANAGEMENT ORGANIZATIONS-FFS PLAN

A = LOCK-IN, CMS TO PROCESS PROVIDER CLAIMS,RISK-TYPE CONTRACT

B = LOCK-IN, HMO TO PROCESS IN-PLAN PART A AND PART B CLAIMS, RISK-TYPE CONTRACT

C = LOCK-IN, HMO TO PROCESS ALL PROVIDER CLAIMS, MEDICARE+CHOICE TYPE CONTRACT