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. § 405.978

Effect of a reconsideration

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A reconsideration is binding on all parties, unless—

(a) An ALJ or attorney adjudicator decision is issued in accordance to a request for an ALJ hearing made in accordance with § 405.1014;

(b) A review entity issues a decision in accordance to a request for expedited access to judicial review under § 405.990; or

(c) The reconsideration is revised as a result of a reopening in accordance with § 405.980.

[70 FR 11472, Mar. 8, 2005, as amended at 74 FR 65334, Dec. 9, 2009; 82 FR 5108, Jan. 17, 2017]
Notes of Decisions
Cited in 3 cases (1 in the last 5 years), 2020–2022 · leading case: Glad v. Medicare/novitas Solutions, No. 2:19-cv-13431 (D.N.J. Jan. 22, 2020).
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Glad v. Medicare/novitas Solutions, No. 2:19-cv-13431 (D.N.J. Jan. 22, 2020). “See 42 CFR §§ 405.978 , 405.1000, 405.1002, 405.”
Glad v. Novitas solutions/medicare, No. 2:19-cv-13902 (D.N.J. Jan. 22, 2020). “See 42 CFR §§ 405.978 , 405.1000, 405.1002, 405.”
First United Methodist Church v. Becerra, No. 8:22-cv-00175 (D. Neb. Dec. 14, 2022). “42 C.F.R. § 405.978 . 3. Reopenings “A reopening is a remedial action taken to change a binding determination or decision that resulted in either an overpayment or underpayment, even though the binding determination or decision may have been correct at the time it was made based…”
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