42 CFR § 422.1018
Notice and effect of initial determinations
June 11, 2020
(a) Notice of initial determination. CMS, as required under 422.756(f)(2), mails notice of an initial determination to the affected party, setting forth the basis or reasons for the determination, the effect of the determination, and the party's right to a hearing, and information about where to file the request for hearing.
(b) Effect of initial determination. An initial determination is binding unless—
(1) The affected party requests a hearing; or
(2) CMS revises its decision.