42 CFR 405, Subpart G - Reconsiderations and Appeals Under Medicare Part A
- § 405.701 — Basis, purpose and definitions.
- § 405.702 — Notice of initial determination.
- § 405.704 — Actions which are initial determinations.
- § 405.705 — Actions which are not initial determinations.
- § 405.706 — Decisions of utilization review committees.
- § 405.708 — Effect of initial determination.
- § 405.710 — Right to reconsideration.
- § 405.711 — Time and place of filing request for reconsideration.
- § 405.712 — Extension of time to request reconsideration.
- § 405.714 — Withdrawal of request for reconsideration.
- § 405.715 — Reconsidered determination.
- § 405.716 — Notice of reconsidered determination.
- § 405.717 — Effect of a reconsidered determination.
- § 405.718 — Expedited appeals process.
- § 405.720 — Hearing; right to hearing.
- § 405.722 — Time and place of filing request for a hearing.
- § 405.724 — Departmental Appeals Board (DAB) review.
- § 405.730 — Court review.
- § 405.732 — Review of a national coverage determination (NCD).
- § 405.740 — Principles for determining the amount in controversy.
- § 405.745 — Amount in controversy ascertained after reconsideration.
- § 405.747 — Dismissal of request for hearing; amount in controversy less than $100.
- § 405.750 — Time period for reopening initial, revised, or reconsidered determinations and decisions or revised decisions of an ALJ or the Departmental Appeals Board (DAB); binding effect of determination and decisions.
- § 405.753 — Appeal of a categorization of a device.
Title 42 published on 2012-10-01
The following are only the Rules published in the Federal Register after the published date of Title 42.
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This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.
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42 USC § 290dd–2 - Confidentiality of records
42 USC § 290dd–3 to 290ee–3 - Omitted
42 USC § 290dd–3 to 290ee–3 - Omitted
§ 1395 - Prohibition against any Federal interference
Title 42 published on 2012-10-01
The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR 405 after this date.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-06159 RIN CMS-1455-NR DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Notice of CMS ruling. The CMS ruling announced in this notice is effective on March 13, 2013. 42 CFR Parts 405, 411, 412, 419, 424, and 489 This notice announces a CMS Ruling that establishes a policy that revises the current policy on Part B billing following the denial of a Part A inpatient hospital claim by a Medicare review contractor on the basis that the inpatient admission was determined not reasonable and necessary. This revised policy is intended as an interim measure until CMS can finalize a policy to address the issues raised by the Administrative Law Judge and Medicare Appeals Council decisions going forward. To that end, elsewhere in this issue of the Federal Register , we published a proposed rule entitled, “Medicare Program; Part B Inpatient Billing in Hospitals,” to propose a permanent policy that would apply on a prospective basis.