Obligation And Prohibition.pdf

Obligation And Prohibition.pdf

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The MSP Statute does not prohibit a non-Federal entity from imposing cost sharing on a Medicare beneficiary if the non-Federal entity and the provider that is not regarded as a Medicare-approved provider have entered into a written agreement. The written agreement must include the terms and conditions under which the provider that is not regarded as a Medicare-approved provider will provide the treatment.

In other cases, the non-Federal entity has a legal obligation to make sure that the cost of the Medicare cost sharing is paid during the period of suspension or after termination of the Federal award.

Costs to non-Federal entities resulting from financial obligations incurred by the non-Federal entity during a suspension or after termination of a Federal award or subaward are not allowable unless the Federal awarding agency or pass-through entity expressly authorizes them in the notice of suspension or termination or subsequently.

(2) The suspension or termination is based on the non-Federal entity’s non-compliance with a Federal statutory, regulatory, or administrative requirement. However, the suspension or termination cannot be based on the non-Federal entity’s failure to comply with a Federal requirement that the non-Federal entity is obligated to comply with. The requirement must be specified in the notice of the suspension or termination.

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