[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR405.450]



[Page 106]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 405_FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED--Table of 

Contents

 

                       Subpart D_Private Contracts

 

Sec. 405.450  Appeals.



    (a) A determination by CMS that a physician or practitioner has 

failed to properly opt-out, failed to maintain opt-out, failed to timely 

renew opt-out, failed to privately contract, or failed to properly 

terminate opt-out is an initial determination for purposes of Sec. 

405.803.

    (b) A determination by CMS that no payment can be made to a 

beneficiary for the services of a physician who has opted-out is an 

initial determination for purposes of Sec. 405.803.