State Operations Manual (Pub. 100-07), Ch. 3 § 3048
Notice to Provider or Supplier - Voluntary Termination
3048 - Notice to Provider or Supplier - Voluntary Termination
(Rev. 1, 05-21-04)
3048A - Voluntary Termination
(Rev. 202, Issued: 06-19-20, Effective: 06-19-20, Implementation: 07-27-20)
The MAC will notify the provider or supplier of approval of voluntary termination. The
MAC sends copies of the letter to the SA, RO, and AO.
For Medicaid-only certified facilities or dually-certified Medicare and Medicaid
facilities, the SA will send notification to the RO and SMA.
3048B - Close of Business
(Rev. 202, Issued: 06-19-20, Effective: 06-19-20, Implementation: 07-27-20)
The RO sends a letter modeled after Exhibit 190 to the provider with copies to the SA,
MAC, and, if appropriate, the SMA. If a supplier is closing, the RO notifies the MAC and
sends a letter modeled after Exhibit 191.