Completing the Determination

10.9.6 - Completing the Determination (Rev. 739, Issued: 11-01-05, Effective: 07-24-03, Implementation: 01-19-06) The contractor shall complete the §903(c) determination within either: a) 60 days of a provider or supplier’s direct request for such a determination if the contractor has jurisdiction to determine both error and all other conditions or b) 45 days of receiving an error-only determination from another entity. However, delays caused by a provider or supplier’s failure to furnish sufficient information, by the failure of another contractor or CMS component to make a proper and timely referral of a matter, or by the failure of CMS to timely clarify proper jurisdiction in a particular matter, are not included within this timeframe. If the contractor cannot complete the determination within the applicable deadline, then the contractor shall furnish notice of such delay to the provider or supplier, shall take no action to impose the penalty at issue, and shall seek to resolve the issues causing the delay. If the contractor determines that all of the conditions specified in §10.2 have been met, then the contractor shall approve the provider or supplier’s request for a penalty waiver and shall not impose, or shall rescind, the penalty at issue. If the contractor determines that any condition among those specified in §10.2 has not been met, then the contractor shall deny the provider or supplier’s request for a penalty waiver and shall thereafter consider the penalty at issue solely under the terms of the authority for imposing such penalty or under such other authority as may be applicable in the circumstance.