What guideline applies when a plan is sanctioned by CMS?

When a plan is sanctioned by the Centers for Medicare & Medicaid Services (CMS), the guideline that applies is that pre-approval is needed for enrollment. This means that individuals seeking to enroll in a sanctioned plan must first obtain approval from CMS before they can be accepted into the program. The need for pre-approval serves to ensure that the quality of the plans being offered meets CMS standards and that beneficiaries are protected in their choices.

In the context of plan sanctions, this requirement is an essential step because it reflects the heightened scrutiny surrounding plans that have failed to comply with CMS guidelines in the past. Therefore, attaining pre-approval helps safeguard the interests of beneficiaries and maintains the integrity of the Medicare program.

While other options suggest alternative enrollment processes, they do not align with the protocols established for sanctioned plans. Thus, understanding the pre-approval requirement is crucial for patients during their enrollment process in situations involving sanctioned plans.