Medicare Claims Processing Manual (Pub. 100-04), Ch. 33 § 10.10
Notice of the Penalty Waiver Determination
10.10 - Notice of the Penalty Waiver Determination
(Rev. 739, Issued: 11-01-05, Effective: 07-24-03, Implementation: 01-19-06)
The contractor shall furnish notice to the provider or supplier of the contractor’s penalty
waiver determination.
If the penalty waiver was not granted in whole or in part, the notice must specify the basis
for the adverse determination. Every notice of a penalty waiver determination must
include statements: a) that the provider or supplier has a right to a reconsideration of the
penalty waiver determination, b) describing the means for filing a request for
reconsideration, c) specifying the deadline for making such a request, and d) that the
provider may also request a hearing and may present written evidence and arguments.
The contractor should elect to furnish notice concerning the penalty waiver determination
coincident with, or in lieu of, its determination regarding the imposition of the penalty
under the penalty authority.