DI 45010.050 Folder Maintenance of Disallowed or Terminated ESRD Medicare Coverage

Whenever R-HI terminates or is disallowed and no subsequent HI coverage exists or no subsequent action has been taken, e.g., the last action regarding the claimant was the R-HI termination, the earnings reviewer will prepare a one year diary under code 2-C-67. The diary form will be annotated “possible referral to FARC.” Upon expiration of the diary, the earnings reviewer will review the file to determine if any subsequent action has been taken since the termination action. If no subsequent action has been taken, get a case control readout to insure no subsequent claim has been filed. If no subsequent action and/or no claim has been filed since the termination, forward the folder to DOS, FRC Unit for shipment to FARC. If a subsequent action has been taken since the R-HI termination, rediary the case for one year. If another claim was filed, take no action if ODO has jurisdiction; but if a PSC has jurisdiction of the subsequent claim, forward the ESRD folder to the PSC for association with the subsequent claim. If a situation arises which may be resolved by review of another folder, ODO should obtain the other folder.