C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 489—PROVIDER AGREEMENTS AND SUPPLIER APPROVAL › Subpart E—Termination of Agreement and Reinstatement After Termination

42 C.F.R. § 489.55

Exceptions to effective date of termination

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(a) Payment is available for up to 30 days after the effective date of termination for:

(1) Inpatient hospital services (including inpatient psychiatric hospital services) and post hospital extended care services (except as specified in paragraph (b) of this section with respect to LTC facilities) furnished to a beneficiary who was admitted before the effective date of termination; and

(2) Home health services and hospice care furnished under a plan established before the effective date of termination.

(b) The Secretary may, as the Secretary determines is appropriate, continue to make payments with respect to residents of a long-term care facility that has submitted a notification of closure as required at § 483.70(l) of this chapter during the period beginning on the date such notification is submitted and ending on the date on which the residents are successfully relocated.

[76 FR 9512, Feb. 18, 2011, as amended at 78 FR 16805, Mar. 19, 2013; 81 FR 68872, Oct. 4, 2016]
Notes of Decisions
Cited in 4 cases (1 in the last 5 years), 1996–2022 · leading case: United States Ex Rel. Landers v. Baptist Mem'l Health Care Corp., 525 F. Supp. 2d 972 (W.D. Tenn. 2007).
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United States Ex Rel. Landers v. Baptist Mem'l Health Care Corp., 525 F. Supp. 2d 972 (W.D. Tenn. 2007). “at 7-13; 42 C.F.R. § 489.55 (2007) (payment available for certain services up to 30 days after termination).”
Int'l Long Term Care, Inc. v. Shalala, 947 F. Supp. 15 (D.D.C. 1996). “See 42 C.F.R. § 489.55 . 5 The irony here is that the Medicare statute is designed to protect the interests of residents of such nursing facilities, and yet it is these very residents who will suffer the most if they are unnecessarily transferred because of a few days’ gap in…”
Beechwood Restorative Care Ctr. v. Thompson, 494 F. Supp. 2d 181 (W.D.N.Y. 2007). “” 42 C.F.R. § 489.55 (a). The May 7 letter also stated that “[a] change in the seriousness of [Beechwood’s] noncompliance to non-immediate jeopardy may result in a change in the remedy selected.”
B. v. Brooks-Lasure (N.D. Cal. 2022). · cites it 3× “21 The federal termination notice gave Laguna Honda an option to continue to receive post- 22 termination funding beyond the 30-day cutoff: 23 CMS is exercising a rare use of discretion under our authority, 42 C.F.R. § 489.55 (b), to provide for a transition period 24 following…”
— 42 C.F.R. § 489.55(b) — 1 case
B. v. Brooks-Lasure (N.D. Cal. 2022). “21 The federal termination notice gave Laguna Honda an option to continue to receive post- 22 termination funding beyond the 30-day cutoff: 23 CMS is exercising a rare use of discretion under our authority, 42 C.F.R. § 489.55 (b), to provide for a transition period 24 following…”
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