What can a provider request if unsatisfied with the decision from the DAB?

A provider can request a judicial review if they are unsatisfied with the decision from the Departmental Appeals Board (DAB). This option is significant because judicial review provides a formal process in which the courts can examine the legal aspects of the DAB's decisions. It allows for a higher level of scrutiny, ensuring that the decision-making process adhered to legal standards and regulations.

A judicial review is typically sought when a party believes that a decision was made in error based on legal interpretation or that it violates statutory or regulatory provisions. Through this process, providers can seek to overturn or modify the decision if the court finds merit in their claims.

In contrast, while formal mediation, re-evaluation by CMS, and additional evidence reviews may be mechanisms in different contexts or types of appeal processes, they do not specifically pertain to the actions that can be taken in response to a DAB decision. Mediation suggests an alternative dispute resolution process, re-evaluation by CMS indicates a reconsideration at the administrative level, and additional evidence review implies a request for further consideration of evidence, none of which offer the judicial mechanism that the judicial review provides.