To view the interactive forms, click on the attachment at the end of this article. The new interactive forms can be completed online, printed and then mailed with no more filling the form out by hand.
Effective for Part B redeterminations (formerly reviews) issued and mailed by Palmetto GBA on or after January 1, 2006, you may appeal the redetermination decision to a Qualified Independent Contractor (QIC). Palmetto GBA will no longer handle these requests. The Centers for Medicare & Medicaid Services (CMS) issued these new guidelines in Change Request (CR) 3939 and CR 3944, and Palmetto GBA published information about this change on our Web site beginning in October 2005.
Following is a summary of the major points of this change.
- Appeals of redeterminations issued are known as reconsiderations and mailed on or after January 1, 2006
- Effective for all redeterminations, your next level of appeal is to the QIC. In order to avoid delays, it is imperative that you direct your requests for reconsideration to the appropriate contractor.
- All requests for reconsideration must be accompanied by any additional documentation to support your request. We strongly recommend that you complete the appropriate Reconsideration Request form and include a copy of your redetermination notice with your request. You may use the reconsideration request form included with your redetermination notice or the appropriate Reconsideration Request form located on our Web site.
last updated on 11/07/2008