Medicare Claims Processing Manual (Pub. 100-04), Ch. 33 § 10.11

Reconsideration of the Penalty Waiver Determination

Last amended: 2005Year: 2005Length: 209 wordsOfficial source
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.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 33 § 10.11: Reconsideration of the Penalty Waiver Determination | Justis AI