A Medicare revocation notice under 42 CFR 424.535 starts two deadlines running at once, and few physician practices or suppliers realize both exist until it is too late to use one of them. A revocation grounded in noncompliance with Medicare enrollment requirements opens a 30-day window to submit a Corrective Action Plan (CAP). Every revocation, regardless of the reason CMS cites, opens a separate 60-day window to request reconsideration. Missing both leaves the revocation in place, along with the reenrollment bar attached to it, before the provider can bill Medicare again.
The Corrective Action Plan Option
CMS accepts a Corrective Action Plan only when the revocation was issued under 424.535(a)(1), the provision covering noncompliance with Medicare enrollment requirements. CMS will not accept a CAP for revocations issued on other grounds, such as a felony conviction, a state license action, or abuse of billing privileges; those revocations go straight to reconsideration if the provider wants to challenge them. A qualifying CAP must reach the Medicare contractor within 30 days of the date on the revocation notice and must include verifiable evidence that the provider currently meets the specific requirement CMS cited as deficient, not a promise to come into compliance later. The contractor then has up to 60 days to approve or deny the CAP. Approval rescinds the revocation outright.
Reconsideration Under 42 CFR 424.545
Reconsideration is available for every revocation reason under 424.535, not just noncompliance, and follows the appeals process in 42 CFR 424.545 and Part 498. The request must reach CMS or the Medicare Administrative Contractor within 60 days of the date on the revocation notice, addressed to whichever entity the notice designates. A hearing officer with no role in the original decision reviews the record and can uphold or overturn the revocation. Filing a CAP does not pause or extend the 60-day reconsideration deadline. A provider eligible for both should file the reconsideration request before the CAP decision arrives, not after, since a denied CAP received after day 60 leaves no path to appeal the revocation itself. For a broader view of when the audit findings behind a revocation warrant counsel, see When to Engage a Medicare Audit Attorney.
CAP and Reconsideration Together
The two remedies answer different questions. A CAP asks CMS to accept that the cited deficiency is now fixed. A reconsideration request asks whether the revocation should have issued at all. A provider revoked for noncompliance can pursue both at once: if CMS approves the CAP, the revocation is rescinded and the reconsideration becomes unnecessary; if CMS denies the CAP, a timely reconsideration request still proceeds. Revocations that trace back to a RAC or other Medicare audit finding, and that often carry a recoupment demand alongside the revocation, benefit from a coordinated Medicare audit defense response, since the same billing pattern usually drives both actions. A revocation left unchallenged past both deadlines takes effect 30 days after the notice mails in most cases and carries a reenrollment bar of 1 to 10 years before CMS will accept a new enrollment application.
A Corrective Action Plan can rescind a Medicare revocation. A reconsideration request challenges whether the revocation should have issued at all. Only one of the two is available for every revocation reason.
Why Early Legal Counsel Is Critical
It is critical that physicians and other Medicare-enrolled providers promptly retain experienced healthcare defense counsel upon receiving a revocation notice, audit finding, or other CMS inquiry. Early legal intervention can protect the provider's rights, ensure the CAP or reconsideration request is filed correctly and on time, avoid inadvertent admissions, preserve relevant defenses, and let counsel communicate with CMS and its contractors on the provider's behalf. Delaying legal representation past either the 30-day or 60-day deadline can foreclose the remedy entirely and expose the provider to the full reenrollment bar.
How Health Law Alliance Can Help
Health Law Alliance defends physicians and other providers through both the Corrective Action Plan and reconsideration process after a Medicare revocation, as part of the firm's Medicare audit defense practice. The firm evaluates which revocation ground applies, builds the compliance record a CAP requires, and prepares the reconsideration record when a CAP is unavailable or denied. If your practice has received a Medicare revocation notice, contact us for a free, confidential consultation.
