{"key":"medicare_part_c_ire","name":"Medicare Advantage (Part C) IRE Reconsideration","regulation_cite":"42 CFR 422.592-422.596","selection_kind":"uphold_or_overturn","assignment_kind":"client_contract","deadlines":{"unit":"calendar_day","determination_days":30,"attest_days":null,"eligibility_days":null},"required_credentials":["MD","DO"],"permitted_factors":[{"key":"ma_plan_terms","label":"Terms of the Medicare Advantage plan and Medicare coverage rules"},{"key":"physician_expertise","label":"Physician review with expertise appropriate to the service at issue"},{"key":"enrollee_record","label":"The enrollee's medical record and case file"}],"fee_rule":{"kind":"not_applicable","single_range":null,"batched_range":null,"fixed_amount_usd":null,"dismissed_amount_usd":null,"paid_by":null}}