Notice of a reconsideration
| Currency | Current through May 31, 2023 |
| Citation | 42 C.F.R. §405.976 |
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4 cases
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Banks v. Sec'y, Dep't of Health & Human Servs.
...From this stage forward, an LCD is no longer binding, even if it remains persuasive. See 42 U.S.C. § 1395ff(c)(3)(B)(ii)(II) ; 42 C.F.R. §§ 405.976(b)(3), 405.1062. In addition, when the propriety of the claim turns on "whether an item or service is reasonable 38 F.4th 91 and necessary for ......
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In Touch Home Health Agency, Inc. v. Azar, Case No. 19 C 1545
...disagree with the previous determination. See 42 U.S.C. § 1395ff(a)(5), (c)(3)(E) ; 42 C.F.R. §§ 405.946, 405.956(b), 405.966, 405.968(a), 405.976(b). If the QIC upholds an overpayment determination on reconsideration, CMS can begin recouping the overpayment even though the administrative a......
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Sahara Health Care, Inc. v. Azar
...content of step one decision); 42 U.S.C. § 1395ff(c)(3)(E) (requiring "a detailed explanation of the decision" at step two); 42 C.F.R. § 405.976(b) (detailing content of step two decision). The process does not end there.At step three, a provider is entitled to a hearing and decision from a......
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Sahara Health Care, Inc. v. Azar
...content of step one decision); 42 U.S.C. § 1395ff(c)(3)(E) (requiring "a detailed explanation of the decision" at step two); 42 C.F.R. § 405.976(b) (detailing content of step two decision). The process does not end there. At step three, a provider is entitled to a hearing and decision from ......