Provider Accurately Presented Circumstances in Writing

10.2.6 - Provider Accurately Presented Circumstances in Writing (Rev. 739, Issued: 11-01-05, Effective: 07-24-03, Implementation: 01-19-06) The sixth condition that must be met is that the provider or supplier must have accurately and fully presented the circumstances (relating to the item, service, or claim) in writing to the Medicare contractor or to CMS. This condition is met if: a) the presentation of circumstances was made by the provider or supplier or by a billing agent, attorney, or other agent acting on behalf of an expressly identified provider or supplier; b) the presentation of circumstances was made, directly or indirectly, to the Medicare contractor or to the CMS component that issued the guidance upon which the provider or supplier relied; c) the presentation of circumstances included all relevant and material facts (NOTE: Although the burden is on the provider or supplier to present all relevant and material facts, if the contractor or CMS component that issued the guidance took notice of certain facts in issuing such guidance, then the contractor implementing this section shall also take notice of such facts as if they had been presented by the provider or supplier.); d) the circumstances were presented accurately, i.e., there was no material ambiguity or misstatement of fact; and e) the presentation was made in writing (the term “writing” is to be broadly construed as specified in §10.2.3).