[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR416.35]



[Page 812]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 416_AMBULATORY SURGICAL SERVICES--Table of Contents

 

              Subpart B_General Conditions and Requirements

 

Sec. 416.35  Termination of agreement.



    (a) Termination by the ASC--(1) Notice to CMS. An ASC that wishes to 

terminate its agreement must send CMS written notice of its intent.

    (2) Date of termination. The notice may state the intended date of 

termination which must be the first day of a calendar month.

    (i) If the notice does not specify a date, or the date is not 

acceptable to CMS, CMS may set a date that will not be more than 6 

months from the date on the ASC's notice of intent.

    (ii) CMS may accept a termination date that is less than 6 months 

after the date on the ASC's notice if it determines that to do so would 

not unduly disrupt services to the community or otherwise interfere with 

the effective and efficient administration of the Medicare program.

    (3) Voluntary termination. If an ASC ceases to furnish services to 

the community, that shall be deemed to be a voluntary termination of the 

agreement by the ASC, effective on the last day of business with 

Medicare beneficiaries.

    (b) Termination by CMS--(1) Cause for termination. CMS may terminate 

an agreement if it determines that the ASC--

    (i) No longer meets the conditions for coverage as specified under 

Sec. 416.26; or

    (ii) Is not in substantial compliance with the provisions of the 

agreement, the requirements of this subpart, and other applicable 

regulations of subchapter B of this chapter, or any applicable 

provisions of title XVIII of the Act.

    (2) Notice of termination. CMS sends notice of termination to the 

ASC at least 15 days before the effective date stated in the notice.

    (3) Appeal by the ASC. An ASC may appeal the termination of its 

agreement in accordance with the provisions set forth in part 498 of 

this chapter.

    (c) Effect of termination. Payment is not available for ASC services 

furnished on or after the effective date of termination.

    (d) Notice to the public. Prompt notice of the date and effect of 

termination is given to the public, through publication in local 

newspapers by--

    (1) The ASC, after CMS has approved or set a termination date; or

    (2) CMS, when it has terminated the agreement.

    (e) Conditions for reinstatement after termination of agreement by 

CMS. When an agreement with an ASC is terminated by CMS, the ASC may not 

file another agreement to participate in the Medicare program unless 

CMS--

    (1) Finds that the reason for the termination of the prior agreement 

has been removed; and

    (2) Is assured that the reason for the termination will not recur.



[47 FR 34094, Aug. 5, 1982, as amended at 52 FR 22454, June 12, 1987; 56 

FR 8844, Mar. 1, 1991; 61 FR 40347, Aug. 2, 1996]



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