Rights of the Assignee of Appeal Rights

270.2.6 - Rights of the Assignee of Appeal Rights (Rev. 4278, Issued: 04-12-19, Effective: 06-13-19, Implementation: 06-13-19) When a valid transfer of appeal rights is executed, the beneficiary transfers all appeal rights involving the item or service at issue to the provider or supplier. The transfer of appeal rights by a beneficiary must be made freely and without coercion. The MAC shall assume that a provider or supplier is not making false or misleading statements, representations or claims about any material fact affecting any person’s rights. However, if the MAC has reason to believe that the assignee is making false or misleading statements, representations or claims about any material fact affecting any person’s rights, it shall refer the matter to the UPIC. A provider or supplier accepting the transfer of appeal rights will have access to personal and confidential medical and other information about a beneficiary. The MAC shall assume that the provider or supplier will not disclose personal or confidential information about a beneficiary except as necessary to pursue an appeal on behalf of the party represented. Further, it shall assume that a provider or supplier is not disclosing any personal or confidential medical or other information about a beneficiary outside of the appeals process. A beneficiary transfers all appeal rights involving the item or service at issue to the provider or supplier, these include, but are not limited to: 1. Obtaining information about the claim to the same extent as the beneficiary; 2. Submitting evidence; 3. Making statements about facts or law; and 4. Making any request, or giving, or receiving any notice about appeal proceedings. When a MAC takes action or issues a redetermination, it shall send notice to only the assignee. Notice shall not be sent to the beneficiary if there is an assignee. The MAC shall send any requests for information or evidence regarding an appeal only to the assignee.