§486.314. Appeals. — Inbound Citations
42 C.F.R. § 486.314
Statutory Authority
Cited by 3 regulations in release Current.
Citations to 42 U.S.C. § 486.314 as a whole
-
(a) A service area is open for competition when the OPO for the service area is de-certified and all administrative appeals under § 486.314 are exhausted.
-
(1) If CMS finds that the OPO has changed to such an extent that it no longer satisfies the requirements for OPO designation, CMS may de-certify the OPO and declare the OPO's service area to be an open area. An OPO may appeal such a de-certification as set forth in § 486.314. The OPO's service area is not opened for competition until the conclusion of the administrative appeals process.
-
(3) An OPO will receive a notice of de-certification determination under § 486.314 and cannot compete for any open DSA if it meets either of the following:(i) Has been shown by survey to not be in compliance with the requirements for certification at § 486.303, including the conditions for coverage at §§ 486.320 through 486.360; or(ii) Has outcome requirements as described in § 486.318(e)(6) at the final assessment period of the agreement cycle.