If, after CDR development, you make a FTFPT determination that a beneficiary has failed
to follow prescribed treatment without good cause, you must send a predetermination notice to the beneficiary.
For the appropriate predetermination notice language, see DI 23010.045.
For Title II CDR cessations based on FTFPT, this notice requirement is based on GN 03001.005. For procedural simplicity, we extend this requirement to all Title II CDR cessations
based on FTFPT, see DI 40515.020A. This notice is not based upon statutory benefit continuation (SBC) provisions because
these cases do not involve medical cessations. See DI 12027.015 Cases Excluded from Statutory Benefit Continuation (SBC).
For Title XVI CDR cessations based on FTFPT, this notice requirement is based on Goldberg/Kelly
procedures because they are non-medical group II deficiency cases, see DI 27540.030A. Send these notices to all relevant people listed in SI 02301.300E.2.
Give the individual 30 days to respond to the predetermination notice.
If the individual does not respond after 30 days, cease the claim.
If the individual responds and provides sufficient evidence of good cause, continue
If the claimant responds but does not provide good cause for FTFPT, cease the claim.
The benefits cessation date for both situations is 30 days after you sent the predetermination