CFR > Title 42 - Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM (parts 405 to 426) > PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED > SUBPART X—Rural Health Clinic and Federally Qualified Health Center Services (§405.2400 to §405.2472) > 405.2404—Terminations of agreements.

405.2404—Terminations of agreements.

(a) Termination by rural health clinic— (1) Notice to Secretary. If the clinic wishes to terminate its agreement it shall file with the Secretary a written notice stating the intended effective date of termination.
(2) Action by the Secretary. (i) The Secretary may approve the date proposed by the clinic, or set a different date no later than 6 months after the date of the clinic's notice.
(ii) The Secretary may approve a date which is less than 6 months after the date of notice if he determines that termination on that date would not:
(A) Unduly disrupt the furnishing of services to the community serviced by the clinic; or
(B) Otherwise interfere with the effective and efficient administration of the Medicare program.
(3) Cessation of business. If a clinic ceases to furnish services to the community, that shall be deemed to be a voluntary termination of the agreement by the clinic, effective on the last day of business.
(b) Termination by the Secretary— (1) Cause for termination. The Secretary may terminate an agreement if he determines that the rural health clinic:
(i) No longer meets the conditions for certification under part 491 of this chapter; or
(ii) Is not in substantial compliance with the provisions of the agreement, the requirements of this subpart, any other applicable regulations of this part, or any applicable provisions of title XVIII of the Act; or
(iii) Has undergone a change of ownership.
(2) Notice of termination. The Secretary will give notice of termination to the rural health clinic at least 15 days before the effective date stated in the notice.
(3) Appeal by the rural health clinic. A rural health clinic may appeal the termination of its agreement in accordance with the provisions set forth in part 498 of this chapter.
(c) Effect of termination. Payment will not be available for rural health clinic services furnished on or after the effective date of termination.
(d) Notice to the public. Prompt notice of the date and effect of termination shall be given to the public, through publication in local newspapers:
(1) By the clinic, after the Secretary has approved or set a termination date; or
(2) By the Secretary, when he has terminated the agreement.
(e) Conditions for reinstatement after termination of agreement by the Secretary. When an agreement with a rural health clinic is terminated by the Secretary, the rural health clinic may not file another agreement to participate in the Medicare program unless the Secretary:
(1) Finds that the reason for the termination of the prior agreement has been removed; and
(2) Is assured that the reason for the termination will not recur.
[43 FR 8261, Mar. 1, 1978, as amended at 52 FR 22454, June 12, 1987]