A determination or decision (initial or revised) regarding a claimant's qualification for or entitlement to payments under title VIII is final as of the date of the notice unless:

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  It is timely appealed (or a civil suit is filed); or

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  It is appealed late but good cause for late filing of a appeal or civil suit is found; or

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  The AC takes jurisdiction on its own motion within 60 days of the date of the hearing decision; or

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  The AC denies a request for review (does not issue a decision), in which case the hearing decision is the final decision as of the date of the notice that the AC denied review; or

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  It is reopened and revised.

The 65-day period (60 days plus 5 days for receipt of the notice) following the date of the initial determination is significant for determining whether an appeal has been filed timely. The date that the appeal period ends has no significance in determining whether a determination or decision is final.

If a change occurs within the appeal period, it does not alter the fact that the initial determination is final and can only be revised if it is appealed or reopened (or the AC initiates own motion review). See GN 04001.040 for an example of a change during the appeal period.