§ 512.755 Timely error notice process.

(a) General. Subject to the limitations on review in § 512.170, an ASM participant may submit a written timely error notice for one or more calculations made and issued by CMS within the ASM performance report if the ASM participant believes an error occurred in calculations due to data quality, misapplication of methodology, or other issues. (b) Requirements. If an ASM participant believes the ASM performance report contains a calculation error as described in paragraph (a) of this section, the ASM participant must submit a written timely error notice, in a form and manner specified by CMS, documenting the calculation error within 30 calendar days of issuance of the ASM performance report, unless specified by CMS. (1) If the ASM participant does not provide written timely error notice in accordance with paragraph (a) of this section, then the ASM performance report is deemed final 30 calendar days after its issuance. (2) Only an ASM participant may submit a written timely error notice described in this section. (3) Sufficiency of information in written timely error notice. (i) CMS determines if the written timely error notice meets the requirements of this section and contains sufficient information to substantiate the request. (ii) If the request is not compliant with the requirements of this section or requires additional information— (A) CMS follows up with the ASM participant to request additional information in a form and manner as specified by CMS; (B) The ASM participant must respond within 10 calendar days of CMS' request for additional information in a form and manner as specified by CMS; and (C) If an ASM participant does not respond in accordance with paragraph (b)(3)(ii)(B) of this section, then the ASM performance report is deemed final. (c) Process. (1) If CMS receives a written timely error notice within 30 calendar days of the issuance of the ASM performance report that CMS determines meets the requirements of paragraph (b) of this section, CMS issues an initial determination in writing within 30 calendar days of receipt to either confirm that there was an error in the calculation or verify that the calculation is correct. (2) CMS reserves the right to extend the time for providing its initial final determination upon written notice to the ASM participant. (d) Reconsideration request. An ASM participant who wishes to dispute an initial determination made in accordance with paragraph (c) of the section may invoke the reconsideration review process under § 512.190.