§ 422.268 - Source of payment and effect of election of the M+C plan election on payment.

(a) Source of payments. Payments under this subpart, to M+C organizations or M+C MSAs, are made from the Federal Hospital Insurance Trust Fund or the Supplementary Medical Insurance Trust Fund. CMS determines the proportions to reflect the relative weight that benefits under Part A, and benefits under Part B represents of the actuarial value of the total benefits under title XVIII of the Act.

(b) Payments to the M+C organization. Subject to §§ 412.105(g) and 413.86(d) of this chapter and §§ 422.109, 422.264, and 422.266, CMS's payments under a contract with an M+C organization (described in § 422.250) with respect to an individual electing an M+C plan offered by the organization are instead of the amounts which (in the absence of the contract) would otherwise be payable under original Medicare for items and services furnished to the individual.

(c) Only the M+C organization entitled to payment. Subject to § 422.262, 422.264, 422.266, and 422.520 of this part and sections 1886(d)(11) and 1886(h)(3)(D) of the Act, only the M+C organization is entitled to receive payment from CMS under title XVIII of the Act for items and services furnished to the individual.