Public Notice - Involuntary Termination

3034 - Public Notice - Involuntary Termination (Rev. 1, 05-21-04) The RO arranges to publish a notice in the local newspaper(s) announcing the termination and the reasons for termination of providers. Public notices are not required for suppliers, except in the case of RHCs (42 CFR 405.2404(d)), Ambulatory Surgical Centers (ASCs) (42 CFR 416.35(d)), and Federally Qualified Health Centers (FQHCs) (42 CFR 405.2442). The RO may place public notices for the termination of other suppliers at its discretion. 3034A - For Providers (Rev. 1, 05-21-04) MEDICARE NOTICE TO THE PUBLIC: Notice is hereby given that the agreement between the (facility/address), and the Secretary of Health and Human Services, as a provider of services in the Health Insurance for the Aged and Disabled Program (Medicare) is to be terminated at the close of (date of termination). 3034B - For Suppliers (Rev. 1, 05-21-04) MEDICARE NOTICE TO THE PUBLIC: Notice is hereby given that effective at the close of (date of termination) the (name and address of facility) is no longer approved for participation in the Medicare program as a supplier of (type of services). The RO inserts the reasons for termination in the format of the following example: The (name of provider) does not comply with the Medicare (Condition of Participation/Requirements of Participation/Condition for Coverage) pertaining to (Condition(s) or Requirement(s) (for SNFs) out of compliance). Add one of the paragraphs below, depending on the type of provider being terminated: 3034C - For Hospitals, CAHs, and SNFs (Rev. 1, 05-21-04) The Medicare program will not make payment for inpatient hospital services (or skilled nursing facility services) furnished to patients who are admitted after the close of (date of termination). For patients admitted on (date of termination), or earlier, payment may continue for up to 30 calendar days of inpatient hospital services (or skilled nursing facility services) furnished after (date of termination). 3034D - For HHAs and Hospices (Rev. 1, 05-21-04) The Medicare program will not make payment for (home health) (hospice) services furnished to patients whose plan of treatment was established after the close of (date of termination). For patients whose plan of treatment was established before (date of termination), payment may be made for up to 30 calendar days after date of termination. 3034E - For Other Providers and Suppliers (Rev. 1, 05-21-04) The Medicare program will not make payment for (type of facility) services furnished to patients after the close of (date of termination). Arrange for publication of notice at least 15 calendar days before the effective date of termination (2 calendar days if immediate jeopardy), but not before the provider or supplier receives notice of termination. The notice advises the provider/supplier of it’s right to due process, the expected schedule for termination action, and that the deficiency must be corrected and verified by the SA to halt the termination. In addition to preparation of legal advertisements, the RO may decide to develop and distribute a press release (via radio/television) on the termination (or other action).