In re LCD Complaint: Nuclear Medicine Study (L35083), DAB CR5729 (2020)


Department of Health and Human Services
DEPARTMENTAL APPEALS BOARD
Civil Remedies Division

Docket No. C-20-681
Decision No. CR5729

DECISION DISMISSING COMPLAINT

In an acknowledgment dated August 7, 2020, the Civil Remedies Division of the Departmental Appeals Board acknowledged that it had received correspondence, dated July 21, 2020, from an aggrieved party.  She characterized her appeal as a challenge to a local coverage determination (LCD) and sought Medicare coverage for a nuclear medicine study that, in her physician’s view, she required.

In the August 7 acknowledgment, I explained the requirements for filing a valid complaint challenging an LCD and determined that the aggrieved party’s submission had not met those requirements.  Citing the requirements of 42 C.F.R. § 426.400(c), I offered the beneficiary an opportunity to file an acceptable complaint and directed her to do so no later than September 8, 2020.  She has not responded to my order.

Because the aggrieved party has not, within the timeframe I established, submitted an acceptable amended complaint, I dismiss this action pursuant to 42 C.F.R. § 426.410(c)(2).