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Code of Federal Regulations (Last Updated: July 5, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B - Medicare Program |
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Part 417 - Health Maintenance Organizations, Competitive Medical Plans, and Health Care Prepayment Plans |
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Subpart Q - Beneficiary Appeals |
§ 417.616 - Request for reconsideration.
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Link to an amendment published at 70 FR 4713, Jan. 28, 2005. (a)
Method and place for filing a request. A request for reconsideration must be made in writing and filed with—(1) The HMO or CMP that made the organization determination;(2) An SSA office; or
(3) In the case of a qualified railroad retirement beneficiary, an RRB office.
(4) In the case of a request for an expedited reconsideration, as provided for in § 417.617 (concerning certain expedited reconsiderations), the HMO or CMP.
(b)
Time for filing a request. Except as provided in paragraph (c) of this section, the request for reconsideration must be filed within 60 days from the date of the notice of the organization determination.(c)
Extension of time to file a request. (1)Rule. If good cause is shown, the HMO or CMP that made the organization determination may extend the time for filing the request for reconsideration.(2)
Method of requesting an extension. If the time limit in paragraph (b) of this section has expired, a party to the organization determination may file a request for reconsideration with the HMO or CMP, CMS, SSA, or, in the case of qualified railroad retirement beneficiary, and RRB office. The request to extend the time limit must—(i) Be in writing; and
(ii) State why the request for reconsideration was not filed timely.
(d)
Parties to the reconsideration. The parties to the reconsideration are the parties to the initial determination as described in § 417.610, and any other person or entity whose rights with respect to the initial determination may be affected by the reconsideration, as determined by the entity that conducts the reconsideration.(e)
Withdrawal of request. A request for reconsideration may be withdrawn by the party who filed the request. The request for withdrawal must be filed at one of the places specified in paragraph (c)(2) of this section.Effective Date Note: At 70 FR 4713, Jan. 28, 2005, § 417.616 was removed, effective January 1, 2006.