Common use of Denial of Payment Clause in Contracts

Denial of Payment. The State will deny payments for new Enrolled Members when, and for so long as, payment for those Enrolled Members is denied by CMS based on the

Denial of Payment. The State will deny payments for new Enrolled Members when, and for so long as, payment for those Enrolled Members is denied by CMS. CMS based on themay deny payment to the State for new Enrolled Members if its determination is not timely contested by the Contractor. See: 42 C.F.R. § 438.726(b); 42 C.F.R. § 438.730(e)(1)(ii); 42 C.F.R. § 457.1270.

Denial of Payment. The State will deny payments for new Enrolled Members when, and for so long as, payment for those Enrolled Members is denied by CMS based on thethe State’s recommendation, when: