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CMS reserves the right to require the state to submit a corrective action plan to CMS for approval. A state corrective action plan could include a temporary suspension of implementation of demonstration programs in circumstances where monitoring data indicate substantial and sustained directional change inconsistent with demonstration goals, such as substantial and sustained trends indicating increased difficulty accessing preventive services. A corrective action plan may be an interim step to withdrawing waivers or expenditure authorities, as outlined in STC 10. CMS will withdraw an authority, as described in STC 10, when metrics indicate substantial and sustained directional change inconsistent with the state’s demonstration goals, and the state has not implemented corrective action. CMS further has the ability to suspend implementation of the demonstration should corrective actions not effectively resolve these concerns in a timely manner.

26. Close out Report. Within one-hundred and twenty (120) calendar days after the expiration of the demonstration, the state must submit a draft Close Out Report to CMS for comments.

a) The draft report must comply with the most current guidance from CMS.

b) In consultation with CMS, and per guidance from CMS, the state will include an evaluation of the demonstration (or demonstration components) that are to phase out or expire without extension along with the Close-Out Report. Depending on the timeline of the phase-out during the demonstration approval period, in agreement with CMS, the evaluation requirement may be satisfied through the Interim and/or Summative Evaluation Reports stipulated in STCs 56 and 57, respectively.

c) The state will present to and participate in a discussion with CMS on the Close-Out report.

d) The state must take into consideration CMS’s comments for incorporation into the final Close-Out Report.

e) A revised Close-Out Report is due to CMS no later than thirty (30) calendar days after receipt of CMS’s comments.

f) A delay in submitting the draft or final version of the Close Out Report may subject the state to penalties described in STC 21.

27. Monitoring Calls. CMS will convene periodic conference calls with the state. a) The purpose of these calls is to discuss ongoing demonstration operation, to include (but not limited to) any significant actual or anticipated developments affecting the demonstration. Examples include implementation activities, trends in reported data on metrics and associated mid-course adjustments, enrollment and access, budget neutrality, and progress on evaluation activities.