42 CFR Subpart I - Subpart I—Determinations, Redeterminations, Reconsiderations, and Appeals Under Original Medicare (Part A and Part B)

  1. § 405.900 Basis and scope.
  2. § 405.902 Definitions.
  3. § 405.903 Prepayment review.
  4. § 405.904 Medicare initial determinations, redeterminations and appeals: General description.
  5. § 405.906 Parties to the initial determinations, redeterminations, reconsiderations, hearings, and reviews.
  6. § 405.908 Medicaid State agencies.
  7. § 405.910 Appointed representatives.
  8. § 405.912 Assignment of appeal rights.
  13. Expedited Access to Judicial Review (§ 405.990)
    1. § 405.990 Expedited access to judicial review.
  14. ALJ Hearings (§§ 405.1000 - 405.1058)
    1. § 405.1000 Hearing before an ALJ and decision by an ALJ or attorney adjudicator: General rule.
    2. § 405.1002 Right to an ALJ hearing.
    3. § 405.1004 Right to a review of QIC notice of dismissal.
    4. § 405.1006 Amount in controversy required for an ALJ hearing and judicial review.
    5. § 405.1008 Parties to the proceedings on a request for an ALJ hearing.
    6. § 405.1010 When CMS or its contractors may participate in the proceedings on a request for an ALJ hearing.
    7. § 405.1012 When CMS or its contractors may be a party to a hearing.
    8. § 405.1014 Request for an ALJ hearing or a review of a QIC dismissal.
    9. § 405.1016 Time frames for deciding an appeal of a QIC reconsideration or escalated request for a QIC reconsideration.
    10. § 405.1018 Submitting evidence.
    11. § 405.1020 Time and place for a hearing before an ALJ.
    12. § 405.1022 Notice of a hearing before an ALJ.
    13. § 405.1024 Objections to the issues.
    14. § 405.1026 Disqualification of the ALJ or attorney adjudicator.
    15. § 405.1028 Review of evidence submitted by parties.
    16. § 405.1030 ALJ hearing procedures.
    17. § 405.1032 Issues before an ALJ or attorney adjudicator.
    18. § 405.1034 Requesting information from the QIC.
    19. § 405.1036 Description of an ALJ hearing process.
    20. § 405.1037 Discovery.
    21. § 405.1038 Deciding a case without a hearing before an ALJ.
    22. § 405.1040 Prehearing and posthearing conferences.
    23. § 405.1042 The administrative record.
    24. § 405.1044 Consolidated proceedings.
    25. § 405.1046 Notice of an ALJ or attorney adjudicator decision.
    26. § 405.1048 The effect of an ALJ's or attorney adjudicator's decision.
    27. § 405.1050 Removal of a hearing request from OMHA to the Council.
    28. § 405.1052 Dismissal of a request for a hearing before an ALJ or request for review of a QIC dismissal.
    29. § 405.1054 Effect of dismissal of a request for a hearing or request for review of QIC dismissal.
    30. § 405.1056 Remands of requests for hearing and requests for review.
    31. § 405.1058 Effect of a remand.
Source:
70 FR 11472, Mar. 8, 2005, unless otherwise noted.