(a) Notice.
- (1) CMS mails notice of a reconsidered determination to the affected party.
- (2) The notice gives the reasons for the determination.
- (3) If the determination is adverse, the notice specifies the conditions or requirements of law or regulations that the affected party fails to meet, and informs the party of its right to a hearing.
(b) Effect. A reconsidered determination is binding unless—
- (1) CMS or the OIG, as appropriate, further revises the revised determination; or
- (2) The revised determination is reversed or modified by a hearing decision.