Medicare Managed Care Manual (Pub. 100-16), Ch. 11 § 80.5

Termination Process When an MA Organization Initiates

Last amended: 2006Year: 2006Length: 230 wordsOfficial source
80.5 - Termination Process When an MA Organization Initiates Contract Termination (Rev. 79, Issued 02-17-06, Effective Date 02-17-06) • The organization must give CMS notice at least 90 days before the intended date of termination which specifies the reasons the MA organization is requesting contract termination. • The organization's Medicare enrollees must be given a CMS-approved notice at least 60 days before the proposed termination effective date and include a description of alternatives available for obtaining Medicare services within the service area, including alternative MA plans, Medigap options, original fee-for- service Medicare. • The MA organization must also notify the public at least 60 days before the termination effective date by publishing a CMS-approved notice in one or more newspapers of general circulation in each community or county located in the MA organization's service area; The effective date of the termination is determined solely by CMS and is at least 90 days after the date CMS receives the MA organization's notice of its intent to terminate the contract. CMS' liability for payment to the MA organization ends as of the first day of the month after the last month for which the contract was in effect. If termination occurs, CMS will not contract with the same organization for 2 years from the date of termination of the previous contract unless the organization meets specified exceptions (see §50 of this chapter).
Medicare Managed Care Manual (Pub. 100-16), Ch. 11 § 80.5: Termination Process When an MA Organization Initiates | Justis AI