Medicare Claims Processing Manual (Pub. 100-04), Ch. 36 § 20.3
No Administrative or Judicial Review
20.3 - No Administrative or Judicial Review
(Rev. 1502; Issued: 05-09-08; Effective/Implementation Date: 06-09-08)
There is no administrative or judicial review for:
•
The awarding of contracts;
•
The establishment of payment amounts;
•
Designation of CBAs;
•
The phase-in of competitive bidding programs;
•
The selection of items for competitive bidding programs; or
•
The bidding structure and number of contract suppliers selected.
A denied claim is not appealable if the denial is based on a determination by CMS that a
competitively bid item was furnished in a CBA in a manner not authorized by 42 CFR 414
Subpart F.