42 CFR § 422.616 - Reopening and revising determinations and decisions.
(a) An organization or reconsidered determination made by an MA organization, a reconsidered determination made by the independent entity described in § 422.592, or the decision of an ALJ or attorney adjudicator or the Council that is otherwise final and binding may be reopened and revised by the entity that made the determination or decision, under the rules in part 405 of this chapter.
(b) Reopening may be at the instigation of any party.
(d) Once an entity issues a revised determination or decision, any party may file an appeal.
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