Title 42

PART 423 SUBPART U

Subpart U - Reopening, ALJ Hearings and ALJ and Attorney Adjudicator Decisions, Council Review, and Judicial Review Source:74 FR 65363, Dec. 9, 2009, unless otherwise noted.

• 42 U.S.C. 1302, 1306, 1395w-101 through 1395w-152, and 1395hh.
• Source: 70 FR 4525, Jan. 28, 2005, unless otherwise noted.

42:3.0.1.1.10.21.11.1	SECTION 423.1968	423.1968 Scope.
42:3.0.1.1.10.21.11.2	SECTION 423.1970-423.1976	423.1970-423.1976 [Reserved]
42:3.0.1.1.10.21.11.3	SECTION 423.1978	423.1978 Reopening determinations and decisions.
42:3.0.1.1.10.21.11.4	SECTION 423.1980	423.1980 Reopening of coverage determinations, redeterminations, reconsiderations, decisions, and reviews.
42:3.0.1.1.10.21.11.5	SECTION 423.1982	423.1982 Notice of a revised determination or decision.
42:3.0.1.1.10.21.11.6	SECTION 423.1984	423.1984 Effect of a revised determination or decision.
42:3.0.1.1.10.21.11.7	SECTION 423.1986	423.1986 Good cause for reopening.
42:3.0.1.1.10.21.11.8	SECTION 423.1990	423.1990 Expedited access to judicial review.
42:3.0.1.1.10.21.11.9	SECTION 423.2000	423.2000 Hearing before an ALJ and decision by an ALJ or attorney adjudicator: General rule.
42:3.0.1.1.10.21.11.10	SECTION 423.2002	423.2002 Right to an ALJ hearing.
42:3.0.1.1.10.21.11.11	SECTION 423.2004	423.2004 Right to a review of IRE notice of dismissal.
42:3.0.1.1.10.21.11.12	SECTION 423.2006	423.2006 Amount in controversy required for an ALJ hearing and judicial review.
42:3.0.1.1.10.21.11.13	SECTION 423.2008	423.2008 Parties to the proceedings on a request for an ALJ hearing.
42:3.0.1.1.10.21.11.14	SECTION 423.2010	423.2010 When CMS, the IRE, or Part D plan sponsors may participate in the proceedings on a request for an ALJ hearing.
42:3.0.1.1.10.21.11.15	SECTION 423.2014	423.2014 Request for an ALJ hearing or a review of an IRE dismissal.
42:3.0.1.1.10.21.11.16	SECTION 423.2016	423.2016 Timeframes for deciding an appeal of an IRE reconsideration.
42:3.0.1.1.10.21.11.17	SECTION 423.2018	423.2018 Submitting evidence.
42:3.0.1.1.10.21.11.18	SECTION 423.2020	423.2020 Time and place for a hearing before an ALJ.
42:3.0.1.1.10.21.11.19	SECTION 423.2022	423.2022 Notice of a hearing before an ALJ.
42:3.0.1.1.10.21.11.20	SECTION 423.2024	423.2024 Objections to the issues.
42:3.0.1.1.10.21.11.21	SECTION 423.2026	423.2026 Disqualification of the ALJ or attorney adjudicator.
42:3.0.1.1.10.21.11.22	SECTION 423.2030	423.2030 ALJ hearing procedures.
42:3.0.1.1.10.21.11.23	SECTION 423.2032	423.2032 Issues before an ALJ or attorney adjudicator.
42:3.0.1.1.10.21.11.24	SECTION 423.2034	423.2034 Requesting information from the IRE.
42:3.0.1.1.10.21.11.25	SECTION 423.2036	423.2036 Description of an ALJ hearing process.
42:3.0.1.1.10.21.11.26	SECTION 423.2038	423.2038 Deciding a case without a hearing before an ALJ.
42:3.0.1.1.10.21.11.27	SECTION 423.2040	423.2040 Prehearing and posthearing conferences.
42:3.0.1.1.10.21.11.28	SECTION 423.2042	423.2042 The administrative record.
42:3.0.1.1.10.21.11.29	SECTION 423.2044	423.2044 Consolidated proceedings.
42:3.0.1.1.10.21.11.30	SECTION 423.2046	423.2046 Notice of an ALJ or attorney adjudicator decision.
42:3.0.1.1.10.21.11.31	SECTION 423.2048	423.2048 The effect of an ALJ's or attorney adjudicator's decision.
42:3.0.1.1.10.21.11.32	SECTION 423.2050	423.2050 Removal of a hearing request from OMHA to the Council.
42:3.0.1.1.10.21.11.33	SECTION 423.2052	423.2052 Dismissal of a request for a hearing before an ALJ or request for review of an IRE dismissal.
42:3.0.1.1.10.21.11.34	SECTION 423.2054	423.2054 Effect of dismissal of a request for a hearing or request for review of an IRE's dismissal.
42:3.0.1.1.10.21.11.35	SECTION 423.2056	423.2056 Remands of requests for hearing and requests for review.
42:3.0.1.1.10.21.11.36	SECTION 423.2058	423.2058 Effect of a remand.
42:3.0.1.1.10.21.11.37	SECTION 423.2062	423.2062 Applicability of policies not binding on the ALJ and Council.
42:3.0.1.1.10.21.11.38	SECTION 423.2063	423.2063 Applicability of laws, regulations, CMS Rulings, and precedential decisions.
42:3.0.1.1.10.21.11.39	SECTION 423.2100	423.2100 Medicare Appeals Council review: general.
42:3.0.1.1.10.21.11.40	SECTION 423.2102	423.2102 Request for Council review when ALJ or attorney adjudicator issues decision or dismissal.
42:3.0.1.1.10.21.11.41	SECTION 423.2106	423.2106 Where a request for review may be filed.
42:3.0.1.1.10.21.11.42	SECTION 423.2108	423.2108 Council Actions when request for review is filed.
42:3.0.1.1.10.21.11.43	SECTION 423.2110	423.2110 Council reviews on its own motion.
42:3.0.1.1.10.21.11.44	SECTION 423.2112	423.2112 Content of request for review.
42:3.0.1.1.10.21.11.45	SECTION 423.2114	423.2114 Dismissal of request for review.
42:3.0.1.1.10.21.11.46	SECTION 423.2116	423.2116 Effect of dismissal of request for Council review or request for hearing.
42:3.0.1.1.10.21.11.47	SECTION 423.2118	423.2118 Obtaining evidence from the Council.
42:3.0.1.1.10.21.11.48	SECTION 423.2120	423.2120 Filing briefs with the Council.
42:3.0.1.1.10.21.11.49	SECTION 423.2122	423.2122 What evidence may be submitted to the Council.
42:3.0.1.1.10.21.11.50	SECTION 423.2124	423.2124 Oral argument.
42:3.0.1.1.10.21.11.51	SECTION 423.2126	423.2126 Case remanded by the Council.
42:3.0.1.1.10.21.11.52	SECTION 423.2128	423.2128 Action of the Council.
42:3.0.1.1.10.21.11.53	SECTION 423.2130	423.2130 Effect of the Council's decision.
42:3.0.1.1.10.21.11.54	SECTION 423.2134	423.2134 Extension of time to file action in Federal District Court.
42:3.0.1.1.10.21.11.55	SECTION 423.2136	423.2136 Judicial review.
42:3.0.1.1.10.21.11.56	SECTION 423.2138	423.2138 Case remanded by a Federal District Court.
42:3.0.1.1.10.21.11.57	SECTION 423.2140	423.2140 Council Review of ALJ or attorney adjudicator decision in a case remanded by a Federal District Court.

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