42 CFR 423, Subpart U - Reopening, ALJ Hearings, MAC review, and Judicial Review
- § 423.1968 — Scope.
- § 423.1970 — Right to an ALJ hearing.
- § 423.1972 — Request for an ALJ hearing.
- § 423.1974 — Medicare Appeals Council (MAC) review.
- § 423.1976 — Judicial review.
- § 423.1978 — Reopening determinations and decisions.
- § 423.1980 — Reopenings of coverage determinations, redeterminations, reconsiderations, hearings and reviews.
- § 423.1982 — Notice of a revised determination or decision.
- § 423.1984 — Effect of a revised determination or decision.
- § 423.1986 — Good cause for reopening.
- § 423.1990 — Expedited access to judicial review.
- § 423.2000 — Hearing before an ALJ: general rule.
- § 423.2002 — Right to an ALJ hearing.
- § 423.2004 — Right to ALJ review of IRE notice of dismissal.
- § 423.2008 — Parties to an ALJ hearing.
- § 423.2010 — When CMS, the IRE, or Part D plan sponsors may participate in an ALJ hearing.
- § 423.2014 — Request for an ALJ hearing.
- § 423.2016 — Timeframes for deciding an Appeal before an ALJ.
- § 423.2018 — Submitting evidence before the ALJ hearing.
- § 423.2020 — Time and place for a hearing before an ALJ.
- § 423.2022 — Notice of a hearing before an ALJ.
- § 423.2024 — Objections to the issues.
- § 423.2026 — Disqualification of the ALJ.
- § 423.2030 — ALJ hearing procedures.
- § 423.2032 — Issues before an ALJ.
- § 423.2034 — When an ALJ may remand a case.
- § 423.2036 — Description of an ALJ hearing process.
- § 423.2038 — Deciding a case without a hearing before an ALJ.
- § 423.2040 — Prehearing and posthearing conferences.
- § 423.2042 — The administrative record.
- § 423.2044 — Consolidated hearing before an ALJ.
- § 423.2046 — Notice of an ALJ decision.
- § 423.2048 — The effect of an ALJ's decision.
- § 423.2050 — Removal of a hearing request from an ALJ to the MAC.
- § 423.2052 — Dismissal of a request for a hearing before an ALJ.
- § 423.2054 — Effect of dismissal of a request for a hearing before an ALJ.
- § 423.2062 — Applicability of policies not binding on the ALJ and MAC.
- § 423.2063 — Applicability of laws, regulations and CMS Rulings.
- § 423.2100 — Medicare appeals council review: general.
- § 423.2102 — Request for MAC review when ALJ issues decision or dismissal.
- § 423.2106 — Where a request for review may be filed.
- § 423.2108 — MAC Actions when request for review is filed.
- § 423.2110 — MAC reviews on its own motion.
- § 423.2112 — Content of request for review.
- § 423.2114 — Dismissal of request for review.
- § 423.2116 — Effect of dismissal of request for MAC review or request for hearing.
- § 423.2118 — Obtaining evidence from the MAC.
- § 423.2120 — Filing briefs with the MAC.
- § 423.2122 — What evidence may be submitted to the MAC.
- § 423.2124 — Oral argument.
- § 423.2126 — Case remanded by the MAC.
- § 423.2128 — Action of the MAC.
- § 423.2130 — Effect of the MAC's decision.
- § 423.2134 — Extension of time to file action in Federal District Court.
- § 423.2136 — Judicial review.
- § 423.2138 — Case remanded by a Federal District Court.
- § 423.2140 — MAC Review of ALJ decision in a case remanded by a Federal District Court.
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.
For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.
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 423 after this date.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-03921 RIN 0938-AR69 CMS-4173-P DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Proposed rule. To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. EST on April 16, 2013. 42 CFR Parts 422 and 423 This proposed rule would implement medical loss ratio (MLR) requirements for the Medicare Advantage Program and the Medicare Prescription Drug Benefit Program under the Patient Protection and Affordable Care Act.
GPO FDSys XML | Text type regulations.gov FR Doc. 2012-26900 RIN 0938-AR11 CMS-1590-FC DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Final rule with comment period. Effective date: The provisions of this final rule with comment period are effective on January 1, 2013 with the exception of provisions in § 410.38 which are effective on July 1, 2013. The incorporation by reference of certain publications listed in the rule was approved by the Director of the Federal Register on May 16, 2012. Comment date: To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on December 31, 2012. (See the SUPPLEMENTARY INFORMATION section of this final rule with comment period for a list of the provisions open for comment.) 42 CFR Parts 410, 414, 415, 421, 423, 425, 486, and 495 This major final rule with comment period addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also implements provisions of the Affordable Care Act by establishing a face-to-face encounter as a condition of payment for certain durable medical equipment (DME) items. In addition, it implements statutory changes regarding the termination of non-random prepayment review. This final rule with comment period also includes a discussion in the Supplementary Information regarding various programs . (See the Table of Contents for a listing of the specific issues addressed in this final rule with comment period.)