42 C.F.R. § 405.929

Current through September 30, 2024
Section 405.929 - Post-payment review
(a) A contractor may select a claim(s) for post-payment review, which is conducted under the reopening authority in § 405.980 .
(b) In conducting a post-payment review, a contractor may issue an additional documentation request to a provider or supplier.
(1) A provider or supplier will be provided 45 calendar days to submit additional documentation in response to a contractor's request, except as stated in paragraph (b)(2) and (c) of this section.
(2) A contractor may accept documentation received after 45 calendar days for good cause. Good cause means situations such as natural disasters, interruptions in business practices, or other extenuating circumstances that the contractor deems good cause in accepting the documentation.
(c) A provider or supplier will be provided 30 calendar days to submit additional documentation in response to a UPIC's request for additional documentation. A UPIC may accept documentation received after 30 calendar days for good cause. Good cause means situations such as natural disasters, interruptions in business practices, or other extenuating circumstances that the UPIC deems good cause in accepting the documentation.
(d) The outcome of a contractor's review will result in either no change to the initial determination or a revised determination under § 405.984 .

42 C.F.R. §405.929

86 FR 65660, Nov. 19, 2021
86 FR 65660, 1/1/2022