Beneficiary Complaint: Prohibition on Submission of New/Additional

5055.3 – Beneficiary Complaint: Prohibition on Submission of New/Additional Medical Information (Rev. 28, Issued: 10-21-16, Effective: 10-21-16, Implementation: 10-21-16) The submission of new and/or additional medical information does not occur in response to the offer of the Opportunity for Discussion because the Reconsideration process (42 CFR §476.140 (a)(3)) provides an opportunity to submit additional information. NOTE: In instances when the practitioner and/or provider requests to submit new and/or additional medical information, the QIO should advise the practitioner and/or provider of his/her right to request a reconsideration and that any new and/or additional medical information can be considered during the reconsideration process. CMS considers it a basic premise of fairness that beneficiaries, practitioners and/or providers are notified of the ability to file a request for reconsideration in connection with complaints filed after July 31, 2014.