42 CFR 426.431 - ALJ's review of the LCD to apply the reasonableness standard.
(a) Required steps. To review the provision(s) listed in the aggrieved party's complaint based on the reasonableness standard, an ALJ must:
(1) Confine the LCD review to the provision(s) of the LCD raised in the aggrieved party's complaint.
(4) Treat as precedential any previous Board decision under § 426.482 that involves the same LCD provison(s), same specific issue and facts in question, and the same clinical conditions.
(5) Issue a decision as described in § 426.447.
(b) Optional steps. The ALJ may do the following to apply the reasonableness standard to the provision(s) listed in the aggrieved party's complaint:
(2) Consider any previous ALJ decision made under § 426.447 regarding the same provision(s) of the LCD under review and for the same clinical conditions.
Title 42 published on 2013-10-01
no entries appear in the Federal Register after this date.