State Operations Manual (Pub. 100-07), Ch. 2 § 2815
De-certification and Competition:
2815 – De-certification and Competition:
(Rev. 111, Issued: 04-11-14, Effective: 04-11-14, Implemetation: 04-11-14)
If an OPO does not meet all 3 outcome measures as outlined in 42 CFR 486.318 or if it
has been shown by survey to be out of compliance with the requirements described in 42
CFR 486.320 through 486. 348, the OPO is de-certified. If the OPO does not appeal the
de-certification, or if the OPO appeals and the reconsideration official and the CMS
hearing officer uphold the de-certification, the OPO’s service area is opened for
competition from other OPOs. The OPO that has been de-certified is not permitted to
compete for its open area or any other open service area.