Nursing facilities, hospitals, and other providers are able to request a reconsideration review of any adverse determinations (as defined in 42 CFR Part 431.201) received for individuals under their care. Adverse determination means a determination made in accordance with sections 1919(b)(3)(F) or 1919(e)(7)(B) of the Act that the individual does not require the level of services provided by a nursing facility, or that the individual does or does not require specialized services.
If an individual disagrees with a determination, that person, or a provider on their behalf, can request a reconsideration of the determination by contacting Kepro within 30 days of receipt of the determination notice. Kepro can be reached by mail, email, phone, or fax as shown below:
Kepro
3653 Cagney Drive, Suite 202
Tallahassee, FL 32309
Phone: 1-866-880-4080
Fax: 1-866-677-4776
Email: FLPASRRMIQuestions@Kepro.com.