Postponement of the Contract Determination's Effective Date

10.3 - Postponement of the Contract Determination's Effective Date (Rev. 122, Issued: 05-27-16, Effective: 06-28-16, Implementation: 06-28-16) For a determination by CMS to terminate a contract with an MAO, the MA contract termination date, as stated in the notice to terminate an MA contract, is stayed if the MAO files a timely request for a hearing. CMS will stay the proposed effective date of the contract determination until a decision is reached by a hearing officer, and, in instances where a CMS Administrator review has been requested and accepted, affirmed by the CMS Administrator. Written notice is issued by the CMS Administrator notifying the MAO of the CMS Administrator’s decision. The CMS Administrator may uphold, reverse, or modify the hearing officer’s decision. If the contract determination (termination) is based on 42 CFR §422.510(b)(2)(i), concerning the imminent and serious health risk to enrollees, the effective date of the termination will not be stayed even if the MAO requests a hearing. Note, for an initial contract, if a final decision is not reached on CMS’ determination by July 15 then CMS may not enter into a contract with the applicant for the following year.