Provider is No Longer Participating in Medicare But is Participating in

30.3 - Provider is No Longer Participating in Medicare But is Participating in Medicaid: One or More Cost Reports Not Filed (Rev.12946, Issued:11-08-24; Effective: 12-10-24; Implementation:12-10-24) Where a provider's agreement under title XVIII has terminated and one or more cost reports have not been submitted the Contractor shall send the Initial demand letter. Requirements for this letter are in Chapter 4, §20. Since this situation involves not only a terminated provider but a provider that has failed to meet the basic obligation (submission of a cost report) for the period when it did participate, the Initial demand letter provides notice that initiation of the procedure for withholding the Federal share of Medicaid payments will begin in 15 calendar days if the Contractor does not receive the cost report. When the provider has not responded, even though the procedures for withholding the Federal share of Medicaid payments have been initiated, the Contractor shall send the Initial demand letter by the 30th calendar day, followed by the ITR letter by the 60th calendar day from the date of the Initial demand letter. This must be done so that if recoupment efforts and the withholding of Medicaid payments are not effective, the case will be ready for referral to the Department of Treasury.