[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: 42CFR411.126]



[Page 405]

 

                         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. 411.126  Reopening of determinations and decisions.



    (a) A determination that a GHP or LGHP is a nonconforming GHP or the 

decision or revised decision of a hearing officer or of the CMS 

Administrator may be reopened within 12 months from the date on the 

notice of determination or decision or revised decision, for any reason 

by the entity that issued the determination or decision.

    (b) The decision to reopen or not to reopen is not appealable.