Parties to the initial determination.
Parties to the initial determination. The parties to the initial determination are the following individuals and entities:
(1) A beneficiary who files a claim for payment under Medicare Part A or Part B or has had a claim for payment filed on his or her behalf, or in the case of a deceased beneficiary, when there is no estate, any person obligated to make or entitled to receive payment in accordance with part 424, subpart E of this chapter. Payment by a third party payer does not entitle that entity to party status.
(2) A supplier who has accepted assignment for items or services furnished to a beneficiary that are at issue in the claim.
(3) A provider of services who files a claim for items or services furnished to a beneficiary.
(4) An applicable plan for an initial determination under § 405.924(b)(16) where Medicare is pursuing recovery directly from the applicable plan. The applicable plan is the sole party to an initial determination under § 405.924(b)(16) (that is, where Medicare is pursuing recovery directly from the applicable plan).