Medicare Claims Processing Manual (Pub. 100-04), Ch. 34 § 10.6.3

Timeframes for Adjudicator to Reopen

Last amended: 2016Year: 2016Length: 73 wordsOfficial source
10.6.3 - Timeframes for Adjudicator to Reopen (Rev. 3568, Issued: 07-29-16, Effective: 09-30-16, Implementation: 09-30-16)A QIC, ALJ or the AC may reopen and revise its reconsideration, hearing decision or review, respectively, under the following conditions: • Within 180 days from the date of its decision for good cause in accordance with 42 CFR 405.986; or, • At any time if the reconsideration, hearing decision or review was procured by fraud or similar fault.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 34 § 10.6.3: Timeframes for Adjudicator to Reopen | Justis AI