{"abstract":"This final rule makes revisions to the Medicare Advantage (MA) program (Part C) and Prescription Drug Benefit Program (Part D) to implement provisions specified in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) (ACA) and make other changes to the regulations based on our experience in the administration of the Part C and Part D programs. These latter revisions clarify various program participation requirements; make changes to strengthen beneficiary protections; strengthen our ability to identify strong applicants for Part C and Part D program participation and remove consistently poor performers; and make other clarifications and technical changes.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2011/04/15/2011-8274.html","cfr_references":[{"chapter":null,"citation_url":null,"part":417,"title":42},{"chapter":null,"citation_url":null,"part":422,"title":42},{"chapter":null,"citation_url":null,"part":423,"title":42}],"citation":"76 FR 21432","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective Dates: These regulations are effective on June 6, 2011, unless otherwise specified in this final rule. Amendments to 42 CFR 422.564, 422.624, and 422.626 published April 4, 2003 at 68 FR 16652 are effective June 6, 2011.","disposition_notes":null,"docket_ids":["CMS-4144-F"],"dockets":[],"document_number":"2011-8274","effective_on":"2011-06-06","end_page":21577,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2011/04/15/2011-8274.xml","html_url":"https://www.federalregister.gov/documents/2011/04/15/2011-8274/medicare-program-changes-to-the-medicare-advantage-and-the-medicare-prescription-drug-benefit","images":{"ER15AP11.020":{"large":"https://img.federalregister.gov/ER15AP11.020/ER15AP11.020_large.png","medium":"https://img.federalregister.gov/ER15AP11.020/ER15AP11.020_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.020/ER15AP11.020_original_size.png"},"ER15AP11.010":{"large":"https://img.federalregister.gov/ER15AP11.010/ER15AP11.010_large.png","medium":"https://img.federalregister.gov/ER15AP11.010/ER15AP11.010_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.010/ER15AP11.010_original_size.png"},"ER15AP11.021":{"large":"https://img.federalregister.gov/ER15AP11.021/ER15AP11.021_large.png","medium":"https://img.federalregister.gov/ER15AP11.021/ER15AP11.021_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.021/ER15AP11.021_original_size.png"},"ER15AP11.000":{"large":"https://img.federalregister.gov/ER15AP11.000/ER15AP11.000_large.png","medium":"https://img.federalregister.gov/ER15AP11.000/ER15AP11.000_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.000/ER15AP11.000_original_size.png"},"ER15AP11.011":{"large":"https://img.federalregister.gov/ER15AP11.011/ER15AP11.011_large.png","medium":"https://img.federalregister.gov/ER15AP11.011/ER15AP11.011_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.011/ER15AP11.011_original_size.png"},"ER15AP11.022":{"large":"https://img.federalregister.gov/ER15AP11.022/ER15AP11.022_large.png","medium":"https://img.federalregister.gov/ER15AP11.022/ER15AP11.022_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.022/ER15AP11.022_original_size.png"},"ER15AP11.001":{"large":"https://img.federalregister.gov/ER15AP11.001/ER15AP11.001_large.png","medium":"https://img.federalregister.gov/ER15AP11.001/ER15AP11.001_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.001/ER15AP11.001_original_size.png"},"ER15AP11.012":{"large":"https://img.federalregister.gov/ER15AP11.012/ER15AP11.012_large.png","medium":"https://img.federalregister.gov/ER15AP11.012/ER15AP11.012_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.012/ER15AP11.012_original_size.png"},"ER15AP11.023":{"large":"https://img.federalregister.gov/ER15AP11.023/ER15AP11.023_large.png","medium":"https://img.federalregister.gov/ER15AP11.023/ER15AP11.023_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.023/ER15AP11.023_original_size.png"},"ER15AP11.002":{"large":"https://img.federalregister.gov/ER15AP11.002/ER15AP11.002_large.png","medium":"https://img.federalregister.gov/ER15AP11.002/ER15AP11.002_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.002/ER15AP11.002_original_size.png"},"ER15AP11.013":{"large":"https://img.federalregister.gov/ER15AP11.013/ER15AP11.013_large.png","medium":"https://img.federalregister.gov/ER15AP11.013/ER15AP11.013_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.013/ER15AP11.013_original_size.png"},"ER15AP11.003":{"large":"https://img.federalregister.gov/ER15AP11.003/ER15AP11.003_large.png","medium":"https://img.federalregister.gov/ER15AP11.003/ER15AP11.003_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.003/ER15AP11.003_original_size.png"},"ER15AP11.014":{"large":"https://img.federalregister.gov/ER15AP11.014/ER15AP11.014_large.png","medium":"https://img.federalregister.gov/ER15AP11.014/ER15AP11.014_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.014/ER15AP11.014_original_size.png"},"ER15AP11.004":{"large":"https://img.federalregister.gov/ER15AP11.004/ER15AP11.004_large.png","medium":"https://img.federalregister.gov/ER15AP11.004/ER15AP11.004_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.004/ER15AP11.004_original_size.png"},"ER15AP11.015":{"large":"https://img.federalregister.gov/ER15AP11.015/ER15AP11.015_large.png","medium":"https://img.federalregister.gov/ER15AP11.015/ER15AP11.015_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.015/ER15AP11.015_original_size.png"},"ER15AP11.005":{"large":"https://img.federalregister.gov/ER15AP11.005/ER15AP11.005_large.png","medium":"https://img.federalregister.gov/ER15AP11.005/ER15AP11.005_medium.png","original_size":"https://img.federalregister.gov/ER15AP11.005/ER15AP11.005_original_size.png"},"ER15AP11.016":{"large":"https://img.federalregister.gov/ER15AP11.016/ER15AP11.016_large.png","medium":"https://img.federalregister.gov/ER15AP11.016/ER15AP11.016_medium.png","original_size":"https://img.fed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