US · guidance
CMS Pub. 100-16, ch. 14, § 10.1
Notice of Contract Determination
CMS sends a written notice to the MAO for every contract determination. The notice
includes the reasons for the determination and specifies the MAO’s right to request a
hearing. Also included are explicit instructions for filing a hearing request.
For CMS-initiated contract terminations, before providing the MAO with notice of CMS’
intent to terminate, CMS will provide the MAO with a reasonable opportunity of at least
30 days to develop and implement a corrective action plan to correct the deficiencies. In
addition, CMS mails the termination notice at least 45 days before the anticipated
effective date of the termination. However, if there is imminent and serious risk to the
health of the individuals enrolled in the MAO, CMS does not need to provide the MAO
with an opportunity to correct and notifies the MAO of its decision to terminate the
MAO’s contract as of a day set forth in its notification letter, with no set period of notice
required.
When CMS determines that it will not renew its contract with an organization, CMS will
notify the organization by August 1 of the current contract year.
History
(Rev. 122, Issued: 05-27-16, Effective: 06-28-16, Implementation: 06-28-16)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a88c5f55ad1f0290972efd5b55030432daabdbbea3df88e386f8ddbe35e7f8fa
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