Chinyere Uduhiri, DAB CR6954 (2026)

DECISION

I affirm the determination of the Centers for Medicare & Medicaid Services (CMS) that the effective date for the reassignment of Medicare benefits from Chinyere Uduhiri, NP (Petitioner) to Comprehensive Rehab Consultants PLLC (Group Practice) is December 9, 2025. 

I.  Procedural History

On May 4, 2026, Petitioner requested a hearing to dispute the effective date for the reassignment of Petitioner’s Medicare benefits to the Group Practice.  On May 11, 2026, the Civil Remedies Division acknowledged the hearing request, provided a prehearing submission schedule to the parties, and issued a copy of my Standing Order and the Civil Remedies Division Procedures (CRDP).  On June 15, 2026, CMS filed a prehearing exchange, which included 4 proposed exhibits.  Petitioner did not file an exchange. 

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II.  Admission of Evidence

Absent objection, I admit all of CMS’s proposed exhibits into the record.  See Standing Order ¶ 10; CRDP § 14(e). 

III.  Decision on the Written Record

I directed the parties to submit written direct testimony for any witnesses they wanted to offer.  Standing Order ¶ 11.  I also informed the parties as follows: 

If the parties either do not file any written direct testimony or the parties do not request to cross-examine any of the witnesses from whom written direct testimony has been submitted, I will consider such actions by the parties to serve as a constructive request for a decision on the written record because there will be no reason to hold an in-person hearing. 

Standing Order ¶ 7(g)(iii); see also CRDP §§ 16(b), 19(b), (d).  I further advised:  “Unless a hearing is required for cross-examination of a witness or witnesses, the record will be closed and the case will be ready for a decision after all the submission deadlines have passed.”  Standing Order ¶ 14. 

Neither party submitted written direct testimony from any witnesses and all submission deadlines have passed.  Therefore, I decide this case on the written record.  Anil Hanuman, D.O., DAB No. 3080 at 11-12 (2022). 

IV.  Issue

Whether December 9, 2025, is the correct effective date for the reassignment of Medicare benefits from Petitioner to the Group Practice. 

V.  Jurisdiction

I have jurisdiction to decide the issue in this case.  42 C.F.R. § 498.3(b)(15). 

VI.  Findings of Fact

1. Petitioner is a nurse practitioner who was enrolled in the Medicare program.  See CMS Ex. 1 at 1; CMS Ex. 2 at 1.
2. On January 8, 2026, CMS received an application for the reassignment of Petitioner’s Medicare benefits to the Group Practice.  CMS Ex. 1 at 1.

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3. In a January 20, 2026 notice of initial determination, a CMS contractor approved Petitioner’s application to reassign Medicare benefits to the Group Practice, effective December 9, 2025.  CMS Ex. 2 at 1.
4. On January 20, 2026, Petitioner requested reconsideration of the effective date for reassignment.  CMS Ex. 3.
5. In a May 1, 2026 reconsidered determination, the CMS contractor upheld the December 9, 2025 effective date for the reassignment of Medicare benefits.  CMS Ex. 4. 

VII.  Conclusion of Law and Analysis

The effective date of reassignment of Petitioner’s Medicare benefits to the Group Practice is December 9, 2025, because CMS received Petitioner’s reassignment application on January 8, 2026, CMS was able to process that application to approval, and CMS properly provided Petitioner with a 30-day retrospective period for the reassignment. 

The Social Security Act (Act) authorizes the Secretary of Health and Human Services (Secretary) to promulgate regulations governing the enrollment process for providers and suppliers.  42 U.S.C. §§ 1302, 1395cc(j).  A “supplier” includes “a physician or other practitioner, a facility, or other entity (other than a provider of services) that furnishes items or services” under the Medicare provisions of the Act.  42 U.S.C. § 1395x(d).  A supplier must enroll in the Medicare program to receive payment for covered items or services.  42 U.S.C. §§ 1395n(a), 1395u(h)(1); 42 C.F.R. § 424.505. 

The Act permits Medicare beneficiaries to assign their Medicare benefits to a physician or non-physician supplier.  42 U.S.C. § 1395u(b)(3)(B)(ii).  In certain circumstances, a supplier who has received an assignment of benefits may reassign those benefits to an employer, individual, or entity with which the supplier has a contractual arrangement.  42 U.S.C. § 1395u(b)(6); 42 C.F.R. § 424.80(b)(1)-(2). 

The effective date for the reassignment of benefits “is the later of the dates identified in [42 C.F.R.] § 424.520(d)(1)(i) and (ii).”  42 C.F.R. § 424.522(a)(1).  Further, retrospective billing under 42 C.F.R. § 424.521(a)(1) may be applied to the reassignment of benefits.  42 C.F.R. § 424.522(a)(2). 

In this case, Petitioner argues that the effective date for reassignment should be October 28, 2025, because that is the date Petitioner began providing services with the Group Practice.  H’rg Req. at 1; CMS Ex. 3 at 1. 

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The effective date for reassignment for a non-physician practitioner is the “later” of the date on which an application is filed that CMS can process to approval or the date on which the non-physician practitioner begins furnishing services at a new practice location.  42 C.F.R. § 424.520(d)(1), (2)(ii) (made applicable to reassignments by 42 C.F.R. § 424.522(a)(1)); see also 73 Fed. Reg. 69,726, 69,769 (Nov. 19, 2008); Donald Dolce, M.D., DAB No. 2685 at 8 (2016) (establishing that the date of filing is the date CMS receives an application.).  In this case, CMS received Petitioner’s reassignment application on January 8, 2026.  This is later than the date Petitioner began providing services at the new Group Practice on October 28, 2025.  Therefore, CMS properly considered January 8, 2026, as the effective date for the reassignment. 

In this matter, CMS decided that it could provide Petitioner with a period of retrospective billing.  For non-physician practitioners, CMS may provide 30 days of retrospective billing generally or 90 days of retrospective billing if there is a Presidentially-declared disaster.  42 C.F.R. § 424.521(a)(1)(i), (2)(ii) (made applicable to reassignments by 42 C.F.R. § 424.522(a)(2).  Because there is no evidence that Petitioner was affected by a Presidentially declared disaster, CMS properly provided a 30-day retrospective period for the reassignment.  Therefore, December 9, 2026, is the correct effective date of reassignment. 

VIII.  Conclusion

I affirm CMS’s determination that the effective date for the reassignment of Medicare benefits from Petitioner to the Group Practice is December 9, 2025.