Page:United States Statutes at Large Volume 114 Part 5.djvu/578

 114 STAT. 2763A-538 PUBLIC LAW 106-554—APPENDIX F applicable information, including clinical experience and medical, technical, and scientific evidence. "(ii) EFFECT OF NATIONAL AND LOCAL COVERAGE DETERMINATIONS. — " (I) NATIONAL COVERAGE DETERMINATIONS. — If the Secretary has made a national coverage determination pursuant to the requirements established under the third sentence of section 1862(a), such determination shall be binding on the qualified independent contractor in making a decision with respect to a reconsideration under this section. " (II) LOCAL COVERAGE DETERMINATIONS. — If the Secretary has made a local coverage determination, such determination shall not be binding on the qualified independent contractor in making a decision with respect to a reconsideration under this section. Notwithstanding the previous sentence, the qualified independent contractor shall consider the local coverage determination in making such decision. "(Ill) ABSENCE OF NATIONAL OR LOCAL COV- ERAGE DETERMINATION.—In the absence of such a national coverage determination or local coverage determination, the qualified independent contractor shall make a decision with respect to the reconsideration based on applicable information, including clinical experience and medical, technical, and scientific evidence. " (C) DEADLINES FOR DECISIONS.— "(i) RECONSIDERATIONS. —Except as provided in clauses (iii) and (iv), the qualified independent contractor shall conduct and conclude a reconsideration under subparagraph (B), and mail the notice of the decision with respect to the reconsideration by not later than the end of the 30-day period beginning on the date a request for reconsideration has been timely filed, " (ii) CONSEQUENCES OF FAILURE TO MEET DEAD- LINE. —In the case of a failure by the qualified independent contractor to mail the notice of the decision by the end of the period described in clause (i) or to provide notice by the end of the period described in clause (iii), as the case may be, the party requesting the reconsideration or appeal may request a hearing before the Secretary, notwithstanding any requirements for a reconsidered determination for purposes of the party's right to such hearing. "(iii) EXPEDITED RECONSIDERATIONS. — The qualified independent contractor shall perform an expedited reconsideration under subsection (b)(1)(F) as follows: "(I) DEADLINE FOR DECISION.— Notwithstanding section 216(j) and subject to clause (iv), not later than the end of the 72-hour period beginning on the date the qualified independent contractor has received a request for such reconsideration and has received such medical or other records needed for such reconsideration, the qualified

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