42 C.F.R. § 405.705 Actions which are not initial determinations.
Title 42 - Public Health
An initial determination under Part A of Medicare does not include determinations relating to: (a) The reasonable cost of items or services furnished under Part A of Medicare; (b) Whether an institution or agency meets the conditions for participation in the program; (c) Whether an individual is qualified for use of the expedited appeals process as provided in §405.718; (d) An action regarding compromise of a claim arising under the Medicare program, or termination or suspension of collection action on such a claim under the Federal Claims Collection Act of 1966 (31 U.S.C. 3711). See 20 CFR 404.515 for overpayment claims against an individual, §405.376 for overpayment claims against a provider, physician or other supplier, and §408.110 for claims concerning unpaid Medicare premiums; (e) The transfer or discharge of residents of skilled nursing facilities in accordance with §483.12 of this chapter; or (f) The preadmission screening and annual resident review processes required by part 483 subparts C and E of this chapter. [45 FR 73932, Nov. 7, 1980; 46 FR 24565, May 1, 1981, as amended at 52 FR 22454, June 12, 1987; 52 FR 48123, Dec. 18, 1987; 57 FR 56504, Nov. 30, 1992; 61 FR 63749, Dec. 2, 1996]
Title 42: Public Health
PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED
Subpart G—Reconsiderations and Appeals Under Medicare Part A
§ 405.705 Actions which are not initial determinations.
