Medicare Claims Processing Manual (Pub. 100-04), Ch. 33 § 10.8
Determining Whether the Guidance Was Erroneous
10.8 - Determining Whether the Guidance Was Erroneous
(Rev. 739, Issued: 11-01-05, Effective: 07-24-03, Implementation: 01-19-06)
Consideration as to whether the guidance at issue was erroneous is based on the standards
specified in §10.2.1.
If the guidance is determined to have been not erroneous under those standards, and if the
contractor also has jurisdiction to complete the penalty waiver determination, then no
further determinations will be made regarding the conditions specified in §10.2 but,
rather, notice will be given to the provider or supplier of an adverse penalty waiver
determination and the case will be closed.
If the guidance is determined to have been not erroneous, but the contractor does not also
have jurisdiction to complete the penalty waiver determination, the case will be referred
to the entity that has such jurisdiction (through the RO or project officer if necessary or
appropriate) with the information the guidance was not erroneous.
If the guidance is determined to have been erroneous and if the contractor also has
jurisdiction to complete the penalty waiver determination, then the contractor shall
complete such determination in accordance with the procedures specified in §10.9.
If the guidance is determined to have been erroneous but the contractor does not have
jurisdiction to complete the penalty waiver determination, then the contractor shall advise
the entity having such jurisdiction (through the RO or project officer if necessary or
appropriate) that the guidance was erroneous, furnishing such additional information as
will facilitate the completion of the penalty waiver determination.