Code of Federal Regulations Title 42. Public Health § 42.423.346 Reopening

(1) For any reason, within 12 months from the date of the notice of the final determination to the Part D sponsor

(2) After that 12–month period, but within 4 years after the date of the notice of the initial or reconsidered determination to the Part D sponsor, upon establishment of good cause for reopening;  or

(3) At any time, in instances of fraud or similar fault of the Part D sponsor or any subcontractor of the Part D sponsor.

(1) New and material evidence that was not readily available at the time the final determination was made is furnished;

(2) A clerical error in the computation of payments was made;  or

(3) The evidence that was considered in making the determination clearly shows on its face that an error was made.