42 C.F.R. §405.375 - Time limits for, and notification of, administrative determination after receipt of rebuttal statement
| Cite as | 42 C.F.R. §405.375 |
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20 cases
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Tucker v. Sebelius, Civil No. 12-5900 (RBK/AMD)
...18 U.S.C. § 1345, 42 C.F.R. § 405.801 (a), 42 C.F.R. § 405.832 (b) (e) of the Social Security Act, as amended, 42 C.F.R. § 405.370, 42 C.F.R. 405.375 (c), 42 C.F.R. § 405.371, 42 C.F.R. § 424.44, 42 U.S.C. § 405 (e) (g)." Compl. p. 1 (quoted verbatim). She also claims that her Fifth, Sixth,......
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Midwest Family Clinic, Inc. v. Shalala, CIV. A. 97-40503.
...consider it together with other pertinent evidence submitted and determine whether the facts justify termination of the suspension. 42 C.F.R. § 405.375(a). The decision to suspend benefits is not a final determination under 42 U.S.C. 405(h) (hereinafter "§ 405(h)").13 Ergo, it is not appeal......
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Long Island Ambulance, Inc. v. Thompson, 01 CV 2083(ADS)(WDW).
...consider its contents together with any other material bearing on the case, and determine whether the facts justify the suspension. 42 C.F.R. § 405.375(a). The carrier then must send written notice of its determination to the provider. 42 C.F.R. § 405.375(b). A determination that a suspensi......
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Total Renal Laboratories, Inc. v. Shalala, 1:99-CV-436-CAM.
...statements or requests for rescission of the suspension, despite the regulatory requirement that the carrier do so within 15 days. 42 C.F.R. § 405.375. On October 1, 1998, shortly before the first suspension was due to expire, the carrier reopened and redetermined plaintiff's claims for the......
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1 firm's commentaries
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Weigh In with Comments on CMS Proposed Rule for Medicare IRP by June 28
...to the Zone Program Integrity Contractor (ZPIC) discretionary authority to suspend payments without appeal rights in accordance with 42 C.F.R. § 405.375(c), the discretionary revocation authority in the proposed rule is troublesome. Providers and suppliers should address due process concern......