Sanctions by CMS Clause Samples
The 'Sanctions by CMS' clause defines the rights and obligations of the parties if the Centers for Medicare & Medicaid Services (CMS) imposes sanctions on a party involved in the agreement. Typically, this clause outlines the procedures to follow if a party is sanctioned, such as notification requirements, potential suspension of services, or termination of the contract. For example, if a healthcare provider is barred from participating in Medicare or Medicaid due to a CMS sanction, the agreement may allow the other party to terminate the relationship immediately. The core function of this clause is to protect parties from regulatory risks and ensure compliance with federal healthcare program requirements.
Sanctions by CMS. DVHA acknowledges that payments for new enrollees under this contract will be denied when, and for so long as, payment for those enrollees is denied by CMS in accordance with the requirements of 42 CFR 438.730.
Sanctions by CMS. Payments provided for under the contract will be denied for new enrollees when, and for so long as, payment for those enrollees is denied by CMS in accordance with the requirements in 42 CFR 438.730. Sanctions may include civil monetary penalties; suspension of all new enrollments, including default enrollment, after the effective date of the sanction; suspension of payment for recipients enrolled after the effective date of the sanction and until CMS or IDHW is satisfied that the reason for imposition of the sanction no longer exists and is not likely to recur; and other additional sanctions allowed under state or federal regulation that address areas of noncompliance.