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Written clinical review criteria must be developed with the involvement of health plan practitioners.

Health plans should have a system for receiving beneficiaries’ grievances about furnished services for which the beneficiary has no further liability for p

All private health care plans should be held accountable for their actions.

Enrollees in private health plans should have appropriate access to, information about, and protections within clinical trials.

Hospice care is ordinarily covered through the Traditional Medicare

Private health plans must prevent improper use or release of personally identifiable medical information.

All health plans serving Medicare beneficiaries must collect and report comparable, independently audited data to demonstrate compliance with national stan