Contract Determinations

10 - Contract Determinations (Rev. 122, Issued: 05-27-16, Effective: 06-28-16, Implementation: 06-28-16) Subpart N of part 42 provides procedures for making and reviewing the following MA contract determinations: • A determination by CMS that an entity is not qualified to enter into an MA contract with CMS; • A determination by CMS that an entity is not qualified to offer a Special Needs Plan (SNP); • A determination by CMS that an entity is not qualified to complete a Service Area Expansion (SAE); • A determination by CMS to terminate a contract with an MA organization (MAO); and • A determination by CMS not to authorize a renewal of a contract with a MAO. Note that SAE determinations are subject to the procedures for making and reviewing MA contract determinations because, at this time, CMS treats SAE applications as new MA contract applications for the newly added areas and they are therefore subject to the same approval standards.