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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 R - Medicare Contract Appeals |
§ 417.692 - Reopening of initial or reconsidered determination or decision of a hearing officer.
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(a)
Initial or reconsidered determination. An initial or reconsidered determination may be reopened and revised by CMS upon its own motion within one year of the date of the notice of determination.(b)
Decision of hearing officer. A decision of a hearing officer that is unfavorable to any party and is otherwise final may be reopened and revised by the hearing officer upon the officer's own motion within one year of the notice of the hearing decision. It may be reopened and revised by another hearing officer designated by CMS if the hearing officer who issued the decision is unavailable.(c)
Notices. (1) The notice of reopening and of any revisions following the reopening is mailed to the parties.(2) The notice of revision specifies the reasons for revisions.