← Glossary · Program areas
Universe Table 4: Part C Effectuations of Overturned Decisions by IRE, ALJ, or MAC (EFF_C)
The ODAG universe listing reconsiderations overturned by the IRE, ALJ or MAC that the plan must effectuate.
Table 4 lists all reconsiderations fully or partially overturned by the IRE, ALJ or MAC that require effectuation, whether pre-service or post-service (payment). The date the sponsoring organization received the overturn decision (Column J) must fall within the universe request period. Cases dismissed or upheld by the reviewer are excluded.
Source: ODAG protocol, Universe Table 4 record layout guidance, PDF p. 34.