PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2403
‘‘(i) the specific reasons for the redetermination; ‘‘(ii) as appropriate, a summary of the clinical or scientific evidence used in making the redetermination; ‘‘(iii) a description of the procedures for obtaining additional information concerning the redetermination; and ‘‘(iv) notification of the right to appeal the redetermination and instructions on how to initiate such an appeal under this section; ‘‘(B) such written notice shall be provided in printed form and written in a manner calculated to be understood by the individual entitled to benefits under part A or enrolled under part B, or both; and ‘‘(C) the individual provided such written notice may obtain, upon request, information on the specific provision of the policy, manual, or regulation used in making the redetermination.’’. (2) RECONSIDERATIONS.—Section 1869(c)(3)(E) (42 U.S.C. 1395ff(c)(3)(E)) is amended— (A) by inserting ‘‘be written in a manner calculated to be understood by the individual entitled to benefits under part A or enrolled under part B, or both, and shall include (to the extent appropriate)’’ after ‘‘in writing,’’; and (B) by inserting ‘‘and a notification of the right to appeal such determination and instructions on how to initiate such appeal under this section’’ after ‘‘such decision,’’. (3) APPEALS.—Section 1869(d) (42 U.S.C. 1395ff(d)) is amended— (A) in the heading, by inserting ‘‘; NOTICE’’ after ‘‘SECRETARY’’; and (B) by adding at the end the following new paragraph: ‘‘(4) NOTICE.—Notice of the decision of an administrative law judge shall be in writing in a manner calculated to be understood by the individual entitled to benefits under part A or enrolled under part B, or both, and shall include— ‘‘(A) the specific reasons for the determination (including, to the extent appropriate, a summary of the clinical or scientific evidence used in making the determination); ‘‘(B) the procedures for obtaining additional information concerning the decision; and ‘‘(C) notification of the right to appeal the decision and instructions on how to initiate such an appeal under this section.’’. (4) SUBMISSION OF RECORD FOR APPEAL.—Section 1869(c)(3)(J)(i) (42 U.S.C. 1395ff(c)(3)(J)(i)) is amended by striking ‘‘prepare’’ and inserting ‘‘submit’’ and by striking ‘‘with respect to’’ and all that follows through ‘‘and relevant policies’’. (d) QUALIFIED INDEPENDENT CONTRACTORS.— (1) ELIGIBILITY REQUIREMENTS OF QUALIFIED INDEPENDENT CONTRACTORS.—Section 1869(c)(3) (42 U.S.C. 1395ff(c)(3)) is amended— (A) in subparagraph (A), by striking ‘‘sufficient training and expertise in medical science and legal matters’’ and inserting ‘‘sufficient medical, legal, and other expertise (including knowledge of the program under this title) and sufficient staffing’’; and
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