Medicare Managed Care Manual (Pub. 100-16), Ch. 5 § 40.5
Reconsideration of a Decision to Deny, Remove or Not Renew
40.5 - Reconsideration of a Decision to Deny, Remove or Not Renew
Deeming Authority
(Rev. 117, Issued: 08-08-14, Effective: 08-08-14, Implementation: 08-08-14)
42 CFR §422.158
An AO that has received a notice of denial of its request for deeming authority (or
specific deeming categories) may request reconsideration in accordance with the Subpart
D of part 488. CMS will reconsider any determination to deny, remove, or not renew the
approval of deeming authority to private AOs, if the AO files a written request for
reconsideration. The request must be filed within 60 days of the receipt of notice of the
adverse determination. The request for reconsideration must specify the findings or issues
with which the AO disagrees, and the reasons for the disagreement.
In response to a request for reconsideration, CMS will provide the AO the opportunity
for an informal hearing that will be conducted by a hearing officer appointed by the
Administrator of CMS. The informal hearing will also provide the AO the opportunity to
present in writing or in person, evidence or documentation to refute the determination to
deny approval, or to withdraw or not renew deeming authority.