42 CFR 405.940 - Right to a redetermination
| Cite as | 42 CFR 405.940 |
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83 practice notes
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Medwin Family Med. & Rehab., P. L.L.C. v. Burwell, Case No. 1:15-cv-151
...must proceed through the following five steps:1. Redetermination. A redetermination is an examination of the initial claim decision. 42 C.F.R. § 405.940 et seq.2. Reconsideration. A reconsideration is an independent review performed by a Qualified Independent Contractor (QIC). 42 C.F.R. § 4......
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Porzecanski v. Azar, No. 18-5222
...See 42 U.S.C. § 1395ff(b)(1)(A). Initially, he must obtain a "redetermination" from the same contractor. See id. § 1395ff(a)(3)(A) ; 42 C.F.R. § 405.940. If unsuccessful, the beneficiary can seek "reconsideration" by a "qualified independent contractor" who is wholly independent of the init......
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Garcia v. Sebelius, CV 10-8820 PA (RZx)
...is dissatisfied with the initial determination, a "redetermination" may be requested by the same contractor. 42 U.S.C. § 1395ff(a)(3); 42 C.F.R. § 405.940. Next, if the claimant is dissatisfied with the contractor's redetermination, a "reconsideration" may be requested by a "qualified indep......
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Gentiva Healthcare Corp. v. Sebelius, Civil Action No. 11–438 (JEB).
...to be an extensive appeals process. Consistent with Medicare regulations governing the appeals process, see42 C.F.R. §§ 405.920, 405.924(b), 405.940–58, Gentiva first sought a redetermination from Cahaba and then sought reconsideration by another Medicare contractor. See A.R. at 467–71, 534......
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81 cases
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Medwin Family Med. & Rehab., P. L.L.C. v. Burwell, Case No. 1:15-cv-151
...must proceed through the following five steps:1. Redetermination. A redetermination is an examination of the initial claim decision. 42 C.F.R. § 405.940 et seq.2. Reconsideration. A reconsideration is an independent review performed by a Qualified Independent Contractor (QIC). 42 C.F.R. § 4......
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Porzecanski v. Azar, No. 18-5222
...See 42 U.S.C. § 1395ff(b)(1)(A). Initially, he must obtain a "redetermination" from the same contractor. See id. § 1395ff(a)(3)(A) ; 42 C.F.R. § 405.940. If unsuccessful, the beneficiary can seek "reconsideration" by a "qualified independent contractor" who is wholly independent of the init......
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Garcia v. Sebelius, CV 10-8820 PA (RZx)
...is dissatisfied with the initial determination, a "redetermination" may be requested by the same contractor. 42 U.S.C. § 1395ff(a)(3); 42 C.F.R. § 405.940. Next, if the claimant is dissatisfied with the contractor's redetermination, a "reconsideration" may be requested by a "qualified indep......
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Gentiva Healthcare Corp. v. Sebelius, Civil Action No. 11–438 (JEB).
...to be an extensive appeals process. Consistent with Medicare regulations governing the appeals process, see42 C.F.R. §§ 405.920, 405.924(b), 405.940–58, Gentiva first sought a redetermination from Cahaba and then sought reconsideration by another Medicare contractor. See A.R. at 467–71, 534......
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