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Title 42: Public Health
CHAPTER IV: CENTERS FOR MEDICARE& MEDICAID SERVICES,DEPARTMENT OF HEALTH ANDHUMAN SERVICES
SUBCHAPTER A: GENERAL PROVISIONS
PART 422: MEDICARE ADVANTAGE PROGRAM
Subpart N: Medicare Contract Determinations and Appeals
422.654 - Reconsidered determination.
A reconsidered determination is a new determination that?
(a) Is based on a review of the contract determination, the evidence and findings upon which that was based, and any other written evidence submitted before notice of the reconsidered determination is mailed, including facts relating to the status of the MA organization subsequent to the contract determination; and
(b) Affirms, reverses, or modifies the initial determination.
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