Notice of Contract Determination

10.1 – Notice of Contract Determination (Rev. 122, Issued: 05-27-16, Effective: 06-28-16, Implementation: 06-28-16) CMS sends a written notice to the MAO for every contract determination. The notice includes the reasons for the determination and specifies the MAO’s right to request a hearing. Also included are explicit instructions for filing a hearing request. For CMS-initiated contract terminations, before providing the MAO with notice of CMS’ intent to terminate, CMS will provide the MAO with a reasonable opportunity of at least 30 days to develop and implement a corrective action plan to correct the deficiencies. In addition, CMS mails the termination notice at least 45 days before the anticipated effective date of the termination. However, if there is imminent and serious risk to the health of the individuals enrolled in the MAO, CMS does not need to provide the MAO with an opportunity to correct and notifies the MAO of its decision to terminate the MAO’s contract as of a day set forth in its notification letter, with no set period of notice required. When CMS determines that it will not renew its contract with an organization, CMS will notify the organization by August 1 of the current contract year.