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e-CFR data is current as of July 7, 2020

Title 45Subtitle ASubchapter BPart 149 → Subpart G


Title 45: Public Welfare
PART 149—REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM


Subpart G—Disclosure of Data Inaccuracies


Contents
§149.600   Sponsor's duty to report data inaccuracies.
§149.610   Secretary's authority to reopen and revise a reimbursement determination.

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§149.600   Sponsor's duty to report data inaccuracies.

A sponsor is required to disclose any data inaccuracies upon which a reimbursement determination is made, including inaccurate claims data and negotiated price concessions, in a manner and at a time specified by the Secretary in guidance.

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§149.610   Secretary's authority to reopen and revise a reimbursement determination.

(a) The Secretary may reopen and revise a reimbursement determination upon the Secretary's own motion or upon the request of a sponsor:

(1) Within 1 year of the reimbursement determination for any reason.

(2) Within 4 years of a reimbursement determination for good cause.

(3) At any time, in instances of fraud or similar fault.

(b) For purposes of this section, the Secretary does not find good cause if the only reason for the revision is a change of legal interpretation or administrative ruling upon which the determination to reimburse was made.

(c) A decision by the Secretary not to revise a reimbursement determination is final and binding (unless fraud or similar fault is found) and cannot be appealed.

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