CMS Pub. 100-06, ch. 3, § 200.4.6

Withdrawal or Dismissal

(Rev. 12261; Issued:09-22-23, Effective: 12-11-23; Implementation:12-11-23)

A. A request for an appeal may be dismissed for any number of reasons, including:

1. Abandonment of the appeal by the appellant.

2. A request is made by the appellant to withdraw the appeal.

3. A determination that an appellant is not a proper party.

4. The amount in controversy requirements have not been met.

5. The appellant has died and no one else is prejudiced by the claims

determination.

B.. Contractors shall perform the following actions following notification of a

withdrawal or dismissal:

1. Update the AR status to remove the appeal status as soon as possible but

no later than 30 calendar days from the notification of the withdrawal or

dismissal of the appeal.

2. Initiate or resume recoupment on the overpayment immediately upon

notice of withdrawal of an appeal.

3. Initiate or resume recoupment following the dismissal issued date from

the QIC.

4. Update the AR status to resume recoupment as soon as possible but no

later than 30 calendar days from the dismissal notification date.

C. For additional guidance, refer to 42 CFR §§405.379, 405.952, 405.972, and

publication 100-04, Medicare Claims Processing Manual Chapter 29 - Appeals of

Claims Decisions.