42 CFR Subpart U - Reopening, ALJ Hearings and ALJ and Attorney Adjudicator Decisions, Council Review, and Judicial Review

  1. § 423.1968 Scope.
  2. §§ 423.1970-423.1976 [Reserved]
  3. § 423.1978 Reopening determinations and decisions.
  4. § 423.1980 Reopening of coverage determinations, redeterminations, reconsiderations, decisions, and reviews.
  5. § 423.1982 Notice of a revised determination or decision.
  6. § 423.1984 Effect of a revised determination or decision.
  7. § 423.1986 Good cause for reopening.
  8. § 423.1990 Expedited access to judicial review.
  9. § 423.2000 Hearing before an ALJ and decision by an ALJ or attorney adjudicator: General rule.
  10. § 423.2002 Right to an ALJ hearing.
  11. § 423.2004 Right to a review of IRE notice of dismissal.
  12. § 423.2006 Amount in controversy required for an ALJ hearing and judicial review.
  13. § 423.2008 Parties to the proceedings on a request for an ALJ hearing.
  14. § 423.2010 When CMS, the IRE, or Part D plan sponsors may participate in the proceedings on a request for an ALJ hearing.
  15. § 423.2014 Request for an ALJ hearing or a review of an IRE dismissal.
  16. § 423.2016 Timeframes for deciding an appeal of an IRE reconsideration.
  17. § 423.2018 Submitting evidence.
  18. § 423.2020 Time and place for a hearing before an ALJ.
  19. § 423.2022 Notice of a hearing before an ALJ.
  20. § 423.2024 Objections to the issues.
  21. § 423.2026 Disqualification of the ALJ or attorney adjudicator.
  22. § 423.2030 ALJ hearing procedures.
  23. § 423.2032 Issues before an ALJ or attorney adjudicator.
  24. § 423.2034 Requesting information from the IRE.
  25. § 423.2036 Description of an ALJ hearing process.
  26. § 423.2038 Deciding a case without a hearing before an ALJ.
  27. § 423.2040 Prehearing and posthearing conferences.
  28. § 423.2042 The administrative record.
  29. § 423.2044 Consolidated proceedings.
  30. § 423.2046 Notice of an ALJ or attorney adjudicator decision.
  31. § 423.2048 The effect of an ALJ's or attorney adjudicator's decision.
  32. § 423.2050 Removal of a hearing request from OMHA to the Council.
  33. § 423.2052 Dismissal of a request for a hearing before an ALJ or request for review of an IRE dismissal.
  34. § 423.2054 Effect of dismissal of a request for a hearing or request for review of an IRE's dismissal.
  35. § 423.2056 Remands of requests for hearing and requests for review.
  36. § 423.2058 Effect of a remand.
  37. § 423.2062 Applicability of policies not binding on the ALJ and Council.
  38. § 423.2063 Applicability of laws, regulations, CMS Rulings, and precedential decisions.
  39. § 423.2100 Medicare Appeals Council review: general.
  40. § 423.2102 Request for Council review when ALJ or attorney adjudicator issues decision or dismissal.
  41. § 423.2106 Where a request for review may be filed.
  42. § 423.2108 Council Actions when request for review is filed.
  43. § 423.2110 Council reviews on its own motion.
  44. § 423.2112 Content of request for review.
  45. § 423.2114 Dismissal of request for review.
  46. § 423.2116 Effect of dismissal of request for Council review or request for hearing.
  47. § 423.2118 Obtaining evidence from the Council.
  48. § 423.2120 Filing briefs with the Council.
  49. § 423.2122 What evidence may be submitted to the Council.
  50. § 423.2124 Oral argument.
  51. § 423.2126 Case remanded by the Council.
  52. § 423.2128 Action of the Council.
  53. § 423.2130 Effect of the Council's decision.
  54. § 423.2134 Extension of time to file action in Federal District Court.
  55. § 423.2136 Judicial review.
  56. § 423.2138 Case remanded by a Federal District Court.
  57. § 423.2140 Council Review of ALJ or attorney adjudicator decision in a case remanded by a Federal District Court.
Source:
74 FR 65363, Dec. 9, 2009, unless otherwise noted.