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.
Appears in 3 contracts
Sources: Idaho Medicaid Provider Agreement, Medicaid Provider Agreement, Medicaid Provider Agreement