SSA/CMS may take action to prevent or correct inequity to the individual when the
individual's SMI or Premium-HI enrollment, termination, or coverage rights are prejudiced
because of the error, misrepresentation, or inaction of an employee or agent of the
The actions include (but are not limited to) the designation of enrollment and coverage
periods, and appropriate adjustment of premium liability.
The actions may be part of the initial claims process, post- adjudicative processing,
or as a result of information or decisions that arise from the appeals processes.
NOTE: In the following sections dealing with equitable relief, when the PSC is mentioned,
the instructions also apply to the FO if District Office Final Authorization (DOFA)