42 CFR 422.580 : Public Health (Part 1 To Parts 1009-1099) — (§ 414.1 To Parts 427-429) — Centers For Medicare & Medicaid Services, Department Of Health And Human Services (Continued) (§ 414.1 To Parts 427-429) — Medicare Program (Continued) (§ 414.1 To Parts 427-429) — Medicare Advantage Program (§ 422.1 To § 422.2615) — Grievances, Organization Determinations And Appeals (§ 422.560 To § 422.626) — Reconsideration defined.
4 Aug 2016
A reconsideration consists of a review of an adverse organization determination, the evidence and findings upon which it was based, and any other evidence the parties submit or the MA organization or CMS obtains.