Medicare Part D Subsidy Rules - Section 20 CFR 418.3670

§ 418.3655

20 CFR Ch. III (4–1–07 Edition)

information. The issues that we will review are the issues with which you disagree. We may consider other issues,
but we will provide you with advance
notice of these other issues as explained in § 418.3625. If you are dissatisfied with our final decision, you may
file an action in Federal district court.
§ 418.3655 How will we notify you of
our decision after our review?
We will mail a written notice of our
decision on the issue(s) you appealed to
you at your last known address. Generally, we will not send a notice if your
subsidy stops because of your death.
The written notice that we send will
tell you:
(a) What our decision is;
(b) The reasons for our decision;
(c) The effect of our decision; and
(d) Your right to judicial review of
the decision.
§ 418.3665 Can your request for a hearing or case review be dismissed?
We will dismiss your request for a
hearing or case review under any of the
following conditions:
(a) At any time before notice of the
decision is mailed, you ask that your
request for administrative review be
withdrawn; or
(b) You failed to request administrative review timely and did not have
good cause for missing the deadline for
requesting review.

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§ 418.3670 How will you be notified of
the dismissal?
We will mail a written notice of the
dismissal of your request for administrative review to you at your last
known address. The dismissal is not
subject to judicial review and is binding on you unless we vacate it. The decision-maker may vacate any dismissal
of your request for administrative review if, within 60 days after the date
you receive the dismissal notice, you
request that the dismissal be vacated
and show good cause why the request
should not be dismissed. The decisionmaker shall advise you in writing of
any action he or she takes.

§ 418.3675 How does our decision affect you?
Our decision is binding unless you
file an action in Federal district court
seeking review of our final decision or
we revise it as provided in § 418.3678.
You may file an action in Federal district court within 60 days after the
date you receive notice of the decision.
You may request that the time for filing an action in Federal district court
be extended. The request must be in
writing and it must give the reasons
why the action was not filed within the
stated time period. The request must
be filed with the decision-maker who
issued the final decision in your case. If
you show that you had good cause for
missing the deadline, we will extend
the deadline. We will use the standards
in § 418.3640 to decide if you had good
cause to miss the deadline.
§ 418.3678 What is the process for correcting Agency clerical errors?
If we become aware within 60 days of
the date of our initial determination or
our decision following a case review or
telephone hearing, that a clerical error
was made in determining whether or
not you are eligible for a subsidy (either in whole or in part), we may issue
a revised initial determination which
would be effective back to the date you
originally filed your application or the
effective date of a subsidy changing
event, provided you meet the requirements in § 418.3101. We may revise an
initial determination or decision regardless of whether such revised determination or decision is favorable or unfavorable to you. If the revised determination or decision (which is a new
initial determination) is not favorable
to you, you will not be responsible for
paying back any subsidy received prior
to the revised determination or decision. We will mail you a notice of the
revised determination which will explain to you that we have made a revised determination and that this determination replaces an earlier determination, how this determination affects your subsidy eligibility, and your
right to request a hearing.

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