Medicare Managed Care Manual (Pub. 100-16), Ch. 17a § 30.1.2
Definition of Final Determination
30.1.2 - Definition of Final Determination
(Rev. 17, 01-01-03)
For purposes of this section, a final determination is deemed to occur:
•
Upon the issuance of both a Notice of Program Reimbursement (NPR) which
includes:
1. A written demand for payment or
2. A written determination of an underpayment by CMS after the cost report is
filed;
•
In the absence of a NPR, upon the issuance of either:
1. A written demand for payment or
2. A written determination of an underpayment by CMS after the cost report is
filed.
Except as required by any subsequent administrative or judicial reversal, interest will
accrue from the date of final determination as specified in this section.