CMS Pub. 100-16, ch. mc86c17d, § 60.1.2

CMS Medicare Entitlement Data

(Rev. 38, 10-31-03)

In some instances, problems may occur that are related to SSA and/or CMS systems. The

cost plan may request a retroactive enrollment when SSA/CMS systems problems delay

processing of applications. These include:

1. Application rejection when Part B entitlement is not reflected on Medicare

records prior to the first month of entitlement (due to possible lag time when a

beneficiary enrolls during a special enrollment period instead of the initial

enrollment period);

2. HIC number changes;

3. Erroneous death notifications;

4. Problems with posting of Medicare Part B premiums; or

5. Any other SSA/CMS systems issue that may cause the Medicare entitlement data

to be incorrect or missing or that may result in an erroneous enrollment rejection

The cost plan should submit requests for review of such cases to CMS.