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:

  1. 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.)

  2. 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 is effective.)

  3. 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.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600401220
HI 00401.220 - Services After Termination - 09/15/1989
Batch run: 01/27/2009
Rev:09/15/1989