Duration

10006.4 - Duration (Rev. 221; Issued: 05-10-24; Effective: 05-10-24; Implemetation:05-10-24) The suspension of payment would end when CMS terminates the provider agreement or when CMS finds the HHA or hospice program to be in substantial compliance with all of the CoPs. No payments are made to reimburse the HHA or hospice program for the time between the date the sanction/remedy was imposed and the date that substantial compliance was achieved. CMS accomplishes the suspension of payment sanction/remedy through written instructions to the appropriate MAC. The CMS Location will send the letter with instructions to the MAC indicating the beginning or ending date of the payment suspension. Generally, if the HHA or hospice program achieves substantial compliance and it is verified by CMS, CMS will resume payments to the HHA or hospice program prospectively from the date it determines that substantial compliance was achieved. If CMS terminates the provider agreement or determines that the HHA or hospice program is in substantial compliance with the CoPs, the HHA or hospice program would not be able to recoup any payments for services provided to Medicare patients admitted during the time the suspension was in place.