C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED › Subpart I—Determinations, Redeterminations, Reconsiderations, and Appeals Under Original Medicare (Part A and Part B)

42 C.F.R. § 405.946

Evidence to be submitted with the redetermination request

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(a) Evidence submitted with the request. When filing the request for redetermination, a party must explain why it disagrees with the contractor's determination and should include any evidence that the party believes should be considered by the contractor in making its redetermination.

(b) Evidence submitted after the request. When a party submits additional evidence after filing the request for redetermination, the contractor's 60 calendar day decision-making time frame is automatically extended for up to 14 calendar days for each submission.

[70 FR 11472, Mar. 8, 2005, as amended at 70 FR 37702, June 30, 2005; 74 FR 65333, Dec. 9, 2009]
Notes of Decisions
Cited in 9 cases (4 in the last 5 years), 2018–2025 · leading case: Accident, Injury & Rehab v. Alex Azar, II, 943 F.3d 195 (4th Cir. 2019).
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Accident, Injury & Rehab v. Alex Azar, II, 943 F.3d 195 (4th Cir. 2019). “See 42 C.F.R. § 405.946 (a); id. § 405.966(a).”
Sahara Health Care, Inc. v. Alex Azar, II, Secreta, 975 F.3d 523 (5th Cir. 2020). “42 C.F.R. §§ 405.946 (a); 405.966(a). If it wants to submit evidence, that is the time: “A provider of services or supplier may not introduce evidence” after step two “unless there is good cause which pre- cluded the introduction of such evidence at or before that…”
Gurpreet Padda v. Xavier Becerra, 37 F.4th 1376 (8th Cir. 2022). “3d at 526 ; 42 C.F.R. §§ 405.946 (a), 405.966(a). Both steps 1 and 2 are to result in a written, reasoned decision.”
Infinity Healthcare Servs., Inc. v. Azar, 349 F. Supp. 3d 587 (S.D. Tex. 2018). “See 42 C.F.R. § 405.946 (a) ("When filing the request for redetermination, a party must explain why it disagrees with the contractor's determination and should include any evidence that the party believes should be considered by the contractor in making its redetermination.”
Med-Cert Home Care v. Becerra, 19 F.4th 828 (5th Cir. 2021). “§ 1395ff(b)(3); 42 C.F.R. §§ 405.946 (a), 405.966(a)(2). After steps one and two, the Medicare statute allows HHS to begin recouping overpayments, and if the provider is ultimately successful in the later steps, HHS must pay it back (with interest).”
In Touch Home Health Agency, Inc. v. Azar (N.D. Ill. 2019). · cites it 2× “See 42 C.F.R. §§ 405.946 , 405.966, 405.968(a).”
Integrity Soc. Work Servs., LCSW, LLC v. AZAR (E.D.N.Y 2021). “” 42 C.F.R. §§ 405.946 , 405.948. Similarly, reconsideration by a QIC is “an independent, on- the-record review of an initial determination, including the redetermination and all issues related to payment of the claim.”
Acute Care Ambulance Serv., LLC v. Alex M. Azar II (S.D. Tex. 2020). “2020) (citing 42 C.F.R. §§ 405.946 (a), 405.966(a)). 162 Wolff v.”
Hospice of East Texas v. Sec'y, US Dep't of Health of Human Servs. (E.D. Tex. 2025). “§ 1395ff(b)(3); 42 C.F.R. §§ 405.946 (a), 405.966(a)(2)).”
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