US · guidance
CMS Pub. 100-04, ch. 34, § 10.2
Refusal to Reopen Is Not an Initial Determination
A finding that a prior determination or decision will not be reopened is not an “initial
determination or decision.” A contractor’s choice not to reopen is not appealable.
Accordingly, the contractor shall not include a statement concerning the right to an
appeal in the notice informing the party that their reopening request cannot be processed.
A party may however request an appeal on the original claim denial, but must do so
within the required timeframes. If a contractor receives a reopening request and does not
believe they can change the determination, they should not process the request.
History
(Rev. 1069, Issued: 09-29-06, Effective: 11-29-06, Implementation: 11-29-06)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
3885e52f4394f99c7a0fa6c8ec46b98d7a45867af65248c5de9ac448d11763bd
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.