Right to Reconsideration. The ACO may request reconsideration of a determination made by CMS pursuant to this Agreement only if such reconsideration is not precluded by Section 1115A(d)(2) of the Act or this Agreement.
(a) Such a request for reconsideration by the ACO must satisfy the following criteria:
i. The request must be submitted to a designee of CMS (“Reconsideration Official”) who—
A. Is authorized to receive such requests; and
B. Did not participate in the determination that is the subject of the reconsideration request.
ii. The request must contain a detailed, written explanation of the basis for the dispute, including supporting documentation.
iii. The request must be made within 30 days of the date of the determination for which reconsideration is being requested via email to CMS at the address specified in Section XXI.A or such other address as may be specified by CMS.
(b) Requests that do not meet the requirements of Section XX.B.1(a) will be denied by the Reconsideration Official.
(c) Within 10 business days of receiving a request for reconsideration, the Reconsideration Official will send to the ACO and to CMS a written acknowledgement of receipt of the reconsideration request. Such an acknowledgement will set forth:
i. The review procedures; and
ii. A schedule that permits each party to submit only one written position paper, including any supporting documentation, for consideration by the Reconsideration Official in support of the party’s position. The submission of any additional papers or supporting documentation will be at the sole discretion of the Reconsideration Official.
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Right to Reconsideration. If an Instructor disagrees with his/her annual evaluation, that Instructor should first meet with the Department Chair in an attempt to reconcile their differences. Such meetings shall not extend the deadlines set forth in Section 7.7 of this Article unless the Instructor and Department Chair jointly agree, in writing, to such an extension. If this attempt at reconciliation should fail and the employee still disagrees with the annual evaluation, the employee may then initiate a reconsideration process as outlined in Section 7.7 of this Article. The decision of the Reconsideration Committee in this process shall be final. This reconsideration process is afforded as an attempt to provide a third party professional evaluation of an Instructor’s performance based upon guidelines outlined in this Article.
Right to Reconsideration. Right to an appeal, including expedited and standard appeals processes and the time frames for such appeals.
Right to Reconsideration. Right to file an Action Appeal, orally or in writing, including expedited and standard Action Appeals processes and the timeframes for Action Appeals.
Right to Reconsideration. If a bargaining unit member disagrees with his/her annual evaluation, that bargaining unit member should first meet with the Department Chair in an attempt to reconcile their differences. Such meetings shall not extend the deadlines set forth in Section 7.7 of this Article unless the bargaining unit member and Department Chair jointly agree, in writing, to such an extension. If this attempt at reconciliation should fail and the bargaining unit member still disagrees with the annual evaluation, the bargaining unit member may then initiate a reconsideration process as outlined in Section 7.7 of this Article. The decision of the Reconsideration Committee in this process shall be final. This reconsideration process is afforded as an attempt to provide a third-party professional evaluation of a bargaining unit member’s performance based upon guidelines outlined in this Article.
Right to Reconsideration. (i) The MDPCP Practice may request reconsideration of a determination made by CMS pursuant to this Agreement only if such reconsideration is not precluded by section 1115A(d)(2) of the Act or this Agreement.
(ii) Any request for reconsideration by the MDPCP Practice must satisfy the following criteria:
(A) The request must be submitted to a designee of CMS (“Reconsideration Official”) who—
(i) Is authorized to receive such requests; and,
(ii) Did not participate in the determination that is the subject of the reconsideration request.
(B) The request must contain a detailed, written explanation of the basis for the dispute, including supporting documentation.
(C) The request must be made within 30 Days of the date of the determination for which reconsideration is being requested via email to CMS at the address specified in Article 16.1 or such other address as may be specified by CMS.
Right to Reconsideration. In situations where there has been a denial of services as not medically necessary without attempting to discuss the matter with the provider who recommended the service, procedure or treatment under review, the provider shall have the opportunity to request a reconsideration of the denial. The reconsideration review shall occur within one (1) business day of receipt of the request, except in cases where reconsideration request is for services which have already been provided.
Right to Reconsideration. The DCE may request reconsideration of a determination made by CMS pursuant to the Agreement only if such reconsideration is not precluded by section 1115A(d)(2) of the Act or the Agreement.
1. Such a request for reconsideration by the DCE must satisfy the following criteria:
a. The request must be submitted to a designee of CMS (“Reconsideration Official”) who—
i. Is authorized to receive such requests;
ii. Did not participate in the determination that is the subject of the reconsideration request; and
iii. May be, but does not have to be, an Inferior Officer.
b. The request must contain a detailed, written explanation of the basis for the dispute, including supporting documentation.
c. The request must be made within 30 Days of the date of the determination for which reconsideration is being requested via email to CMS at the address specified in Section 19.01 or such other address as may be specified by CMS.
2. Requests that do not meet the requirements of Section 18.02.A.1 will be denied by the Reconsideration Official.
3. Within 10 business Days of receiving a request for reconsideration, the Reconsideration Official will send to the DCE and to CMS a written acknowledgement of receipt of the reconsideration request. Such an acknowledgement will set forth:
a. The review procedures; and
b. A schedule that permits each party to submit documentation in support of the party's position for consideration by the Reconsideration Official.
Right to Reconsideration. Within 60 days of receipt of the information described in 12.1 above, the claimant shall, if he desires further review, file a written request for reconsideration with the Administrator.
