Medicare Claims Processing Manual (Pub. 100-04), Ch. 33 § 10.11
Reconsideration of the Penalty Waiver Determination
10.11 - Reconsideration of the Penalty Waiver Determination
(Rev. 739, Issued: 11-01-05, Effective: 07-24-03, Implementation: 01-19-06)
A provider or supplier may request a reconsideration of an adverse penalty waiver
determination.
The provider or supplier must file such request for reconsideration in accordance with the
procedures and deadline specified in the notice of the adverse determination described in
§10.10 above.
If a request for reconsideration is timely filed by the provider or supplier, the contractor
shall reconsider its penalty waiver determination and shall allow the provider or supplier
to be heard concerning the basis of the provider or supplier’s request or to submit written
arguments and evidence in support of its contentions, provided such written arguments
and evidence are submitted within 30 days of the provider or supplier’s request for
reconsideration or within 10 days of any hearing that may be requested on the matter,
whichever is later.
The contractor shall complete its reconsideration within 30 days of receiving such
request, of any hearing that may be conducted on the matter, or of any filing of written
arguments or evidence, whichever is later.
The contractor shall make a reconsideration decision based on the standards specified in
this section and furnish appropriate notice of such decision to the provider or supplier.