[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: 42CFR411.120]



[Page 402]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 411_EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT

--Table of Contents

 

Subpart E_Limitations on Payment for Services Covered Under Group Health 

                        Plans: General Provisions

 

Sec. 411.120  Appeals.



    (a) Parties to the determination. The parties to the determination 

are CMS, the GHP or LGHP for which CMS determined nonconformance, and 

any employers or employee organizations that contributed to the plan 

during the calendar year for which CMS determined nonconformance.

    (b) Request for hearing. (1) A party's request for hearing must be 

in writing (not in facsimile or other electronic medium) and in the 

manner stipulated in the notice of nonconformance; it must be filed 

within 65 days from the date on the notice.

    (2) The request may include rationale showing why the parties 

believe that CMS's determination is incorrect and supporting 

documentation.

    (3) A request is considered filed on the date it is received by the 

appropriate office, as shown by the receipt date stamped on the request.