US · guidance
CMS Pub. 100-04, ch. 29, § 300.4
Medical Consultants Used
The parties are entitled to know the identity and qualifications of any consultant whose evidence the MAC
used to support the initial claim determination or the redetermination. If the MAC uses a consultant, it shall
include the identity and qualifications of the consultant in the file for possible use by the ALJ, and for the
appellant’s use upon request. This applies to both external medical consultants and internal staff used to
review the claim. An example of this would be the name and title of the medical consultant.
History
(Rev. 1274, Issued: 06-29-07, Effective: 07-01-07, Implementation: 10-01-07)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
dcc36b1737bfd04ae76d94f8fa211e26a38cc236d9a10d54635342610c6ad6b6
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