42 CFR Subpart R - Provider Reimbursement Determinations and Appeals

  1. § 405.1801 Introduction.
  2. § 405.1803 Contractor determination and notice of amount of program reimbursement.
  3. § 405.1804 Matters not subject to administrative and judicial review under prospective payment.
  4. § 405.1805 Parties to contractor determination.
  5. § 405.1807 Effect of contractor determination.
  6. § 405.1809 Contractor hearing procedures.
  7. § 405.1811 Right to contractor hearing; contents of, and adding issues to, hearing request.
  8. § 405.1813 Good cause extension of time limit for requesting a contractor hearing.
  9. § 405.1814 Contractor hearing officer jurisdiction.
  10. § 405.1815 Parties to proceedings before the contractor hearing officer(s).
  11. § 405.1817 Hearing officer or panel of hearing officers authorized to conduct contractor hearing; disqualification of officers.
  12. § 405.1819 Conduct of contractor hearing.
  13. § 405.1821 Prehearing discovery and other proceedings prior to the contractor hearing.
  14. § 405.1823 Evidence at contractor hearing.
  15. § 405.1825 Witnesses at contractor hearing.
  16. § 405.1827 Record of proceedings before the contractor hearing officer(s).
  17. § 405.1829 Scope of authority of contractor hearing officer(s).
  18. § 405.1831 Contractor hearing decision.
  19. § 405.1832 Contractor hearing officer review of compliance with the substantive reimbursement requirement of an appropriate cost report claim.
  20. § 405.1833 Effect of contractor hearing decision.
  21. § 405.1834 CMS reviewing official procedure.
  22. § 405.1835 Right to Board hearing; contents of, and adding issues to, hearing request.
  23. § 405.1836 Good cause extension of time limit for requesting a Board hearing.
  24. § 405.1837 Group appeals.
  25. § 405.1839 Amount in controversy.
  26. § 405.1840 Board jurisdiction.
  27. § 405.1842 Expedited judicial review.
  28. § 405.1843 Parties to proceedings in a Board appeal.
  29. § 405.1845 Composition of Board; hearings, decisions, and remands.
  30. § 405.1847 Disqualification of Board members.
  31. § 405.1849 Establishment of time and place of hearing by the Board.
  32. § 405.1851 Conduct of Board hearing.
  33. § 405.1853 Board proceedings prior to any hearing; discovery.
  34. § 405.1855 Evidence at Board hearing.
  35. § 405.1857 Subpoenas.
  36. § 405.1859 Witnesses.
  37. § 405.1861 Oral argument and written allegations.
  38. § 405.1863 Administrative policy at issue.
  39. § 405.1865 Record of administrative proceedings.
  40. § 405.1867 Scope of Board's legal authority.
  41. § 405.1868 Board actions in response to failure to follow Board rules.
  42. § 405.1869 Scope of Board's authority in a hearing decision.
  43. § 405.1871 Board hearing decision.
  44. § 405.1873 Board review of compliance with the reimbursement requirement of an appropriate cost report claim.
  45. § 405.1875 Administrator review.
  46. § 405.1877 Judicial review.
  47. § 405.1881 Appointment of representative.
  48. § 405.1883 Authority of representative.
  49. § 405.1885 Reopening a contractor determination or reviewing entity decision.
  50. § 405.1887 Notice of reopening; effect of reopening.
  51. § 405.1889 Effect of a revision; issue-specific nature of appeals of revised determinations and decisions.
Authority:
Secs. 205, 1102, 1814(b), 1815(a), 1833, 1861(v), 1871, 1872, 1878, and 1886 of the Social Security Act (42 U.S.C. 405, 1302, 1395f(b), 1395g(a), 1395l, 1395x(v), 1395hh, 1395ii, 1395oo, and 1395ww).
Source:
39 FR 34515, Sept. 26, 1974, unless otherwise noted. Redesignated at 42 FR 52826, Sept. 30, 1977.
Editorial Note:
Nomenclature changes to subpart R of part 405 appear at 79 FR 55031, Aug. 22, 2014.