CMS’ RDS Center would like to remind the Plan Sponsor community that, pursuant to §423.888, there are multiple scenarios during the Payment Validation process that can delay or stop a payment request from being processed. Furthermore, payments that remain on hold for 60 days and are not resolved by the Plan Sponsor are subject to cancellation by the RDS Center.
In 2024, CMS’ RDS Center will publish new guidance for resolving common scenarios that cause payment requests to be placed on hold. This guidance will help Plan Sponsors avoid unnecessary delays and receive subsidy dollars in a timely manner.
CMS’ RDS Center will communicate additional information in the coming weeks.
If you have questions about this information, please contact CMS’ RDS Center.