CMS’ RDS Center would like to remind the Plan Sponsor community that, pursuant to 42 C.F.R. 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.
New guidance for resolving common scenarios that cause payment requests to be placed on hold have been published in the RDS User Guide and Common Questions. This guidance will help Plan Sponsors avoid unnecessary delays and receive subsidy dollars in a timely manner. For more information, refer to:
- Payment Requests Placed on Hold
- Common Question 900-9: My interim payment request is on hold; what should I do?
- Common Question 1000-13: My Reconciliation final payment request is on hold; what should I do?
If you need more information, contact CMS' RDS Center.