HI 00401.220 Services After Termination
Effective with the date a provider agreement is terminated, no payment will be made to the provider under the agreement for:
Inpatient hospital services (including inpatient tuberculosis and inpatient psychiatric
hospital services) and posthospital extended care services furnished to patients who
are admitted on or after the termination date. (Payment can continue to be made for up to 30 days of inpatient
hospital or extended care services furnished on or after the termination date for
beneficiaries admitted prior to the termination date.)
Home health services furnished under a plan which is established on or after the termination
date. (However, if the plan was established before the termination date, payment can
be made for services furnished through the calendar year in which the termination
Other items and services, including outpatient physical therapy or speech pathology
and diagnostic services, furnished on or after the effective date of termination.
The Medicare regional office ascertains from the provider the names and claim numbers
of Medicare beneficiaries entitled to have payment made on their behalf after the
effective date of termination of the provider agreement. The regional office periodically
checks with the intermediary to assure that an institution whose agreement is terminated
continues to bill the program for covered services furnished these beneficiaries.
The regional office periodically checks with the intermediary to assure that the terminated
institution continues to submit “no payment” death or discharge bills for the period after termination, for at least as long as
the institution continues to submit payment bills.