---
kind: "section"
citation: "42 C.F.R. § 460.42"
title: "42"
number: "460.42"
heading: "Suspension of enrollment or payment by CMS."
url: "https://uscodex.org/cfr/42/460.42"
---

# §460.42. Suspension of enrollment or payment by CMS.

- (a) **Enrollment.** If a PACE organization commits one or more violations specified in [§ 460.40](/cfr/42/460.40.md), CMS may suspend enrollment of Medicare beneficiaries after the date CMS notifies the organization of the violation.
- (b) **Payment.** If a PACE organization commits one or more violations specified in [§ 460.40](/cfr/42/460.40.md), for individuals enrolled after the date CMS notifies the PACE organization of the violation, CMS may take the following actions:
  - (1) **Suspend Medicare payment to the PACE organization.**
  - (2) Deny payment to the State for medical assistance for services furnished under the PACE program agreement.
- (c) **Term of suspension.** A suspension or denial of payment remains in effect until CMS is satisfied that the following conditions are met:
  - (1) **The PACE organization has corrected the cause of the violation.**
  - (2) **The violation is not likely to recur.**

## Notes

### Authority

Authority: 42 U.S.C. 1302, 1395, 1395eee(f), and 1396u-4(f).

### Source

Source: 64 FR 66279, Nov. 24, 1999, unless otherwise noted.