Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: July 08, 2016

Program Area: ACA Financial Appeals (ACA FA)

Question: If an issuer is currently waiting to resolve a discrepancy with the Centers for Medicare & Medicaid Services (CMS) and has not received communication from CMS concerning the discrepancy, should the issuer file a request for reconsideration while the discrepancy remains unresolved?

Answer: Yes. Any issuer with an outstanding discrepancy prior to the August 1, 2016 deadline should submit a request for reconsideration while awaiting the discrepancy's resolution. Issuers can withdraw a request for reconsideration if the discrepancy is resolved after the deadline; however, issuers cannot submit a new request for reconsideration after August 1, 2016 deadline.

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