42 C.F.R. § 403.756
Sunset provision.
Cite as 42 C.F.R. § 403.756 (2026)
(a)
Effective date.
Beginning with FFY 2002, if the level of estimated expenditures for all RNHCIs exceeds the trigger level for 3 consecutive FFYs, CMS will not accept as the basis for payment of any claim any election executed on or after January 1 of the following calendar year.
(b)
Notice of activation.
A notice in the
Federal Register
will be published at least 60 days before January 1 of the calendar year that the sunset provision becomes effective.
(c)
Effects of sunset provision.
Only those beneficiaries who have a valid election in effect before January 1 of the year in which the sunset provision becomes effective will be able to claim Medicare payment for care in an RNHCI, and only for RNCHI services furnished during that election.