US · guidance
CMS Pub. 100-04, ch. 30, § 150.5.2.4
Presumption for Constructive Notice
In determining whether the supplier knew, or could reasonably have been expected to
know, that Medicare would deny payment in advance under §1834(a)(15) of the Act,
presume that the supplier knew that Medicare would not pay in all cases in which the
supplier failed to request a mandatory advance determination, on the basis of constructive
notice of the lists of items and of suppliers to the supplier through the contractor’s regular
newsletter/bulletin publication. The supplier would have to submit convincing evidence
to the contrary to rebut this presumption.
History
(Rev. 1587, Issued: 09-05-08, Effective: 03-03-08, Implementation: 03-01-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
aa271e46d44fd14d63176db05972445b4e09b7ed9fac6a48b08f19833877d9c4
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.