| Proceedings covered |
Statutory authority |
Applicable regulations |
|
Office of Inspector General |
| 1. Proceedings to
impose civil monetary penalties, assessments, or exclusions from
Medicare and State health care programs |
42 U.S.C. 1320a-7a(c)(2);
1320b-10(c); 1395i-3(b)(3)(B)(ii), (g)(2)(A)(i); 1395l(h)(5)(D),
(i)(6); 1395m(a)(11)(A), (a)(18), (b)(5)(C), (j)(2)(A)(iii);
1395u(j)(2), (k), (l)(3), (m)(3), (n)(3), (p)(3)(A);
1395y(b)(3)(C), (b)(6)(B); 1395cc(g); 1395dd(d)(1)(A), (B);
1395mm(i)(6)(B); 1395nn(g)(3), (4); 1395ss(d); 1395bbb(c)(1);
1396b(m)(5)(B); 1396r(b)(3)(B)(ii), (g)(2)(A)(i); 1396t(i)(3);
11131(c); 11137(b)(2) |
42 CFR part 1003; 42 CFR part
1005. |
| 2. Appeals of
exclusions from Medicare and State health care programs and/or
other programs under the Social Security Act |
42 U.S.C. 1320a-7(f);
1395l(h)(5)(D); 1395m(a)(11)(A), (b)(5)(C); 1395u(j)(2), (k),
(l)(3), (m)(3), (n)(3), (p)(3)(B) |
42 CFR part 1001; 42 CFR part
1005. |
| 3. Appeal of
exclusions from programs under the Social Security Act, for which
services may be provided on the recommendation of a Peer Review
Organization |
42 U.S.C. 1320c-5(b)(4),
(5) |
42 CFR part 1004; 42 CFR part
1005. |
| 4. Proceedings to
impose civil penalties and assessments for false claims and
statements |
31 U.S.C. 3803 |
45 CFR part 79. |
|
Centers for Medicare & Medicaid Services |
| 1. Proceedings to
suspend or revoke licenses of clinical laboratories |
42 U.S.C. 263a(i);
1395w-2 |
42 CFR part 493, Subpart
R. |
| 2. Proceedings
provided to a fiscal intermediary before assigning or reassigning
Medicare providers to a different fiscal intermediary |
42 U.S.C. 1395h(e)(1)-(3) |
42 CFR 421.114, 421.128. |
| 3. Appeals of
determinations that an institution or agency is not a Medicare
provider of services, and appeals of terminations or nonrenewals of
Medicare provider agreements |
42 U.S.C. 1395cc(h);
1395dd(d)(1)(A) |
42 CFR 489.53(d); 42 CFR part
498. |
| 4. Proceedings
before the Provider Reimbursement Review Board when Department
employees appear as counsel for the intermediary |
42 U.S.C. 1395oo |
42 CFR part 405, Subpart
R. |
| 5. Appeals of CMS
determinations that an intermediate care facility for the mentally
retarded (ICFMR) no longer qualifies as an ICFMR for Medicaid
purposes |
42 U.S.C. 1396i |
42 CFR part 498. |
| 6. Proceedings to
impose civil monetary penalties, assessments, or exclusions from
Medicare and State health care programs |
42 U.S.C.
1395i-3(h)(2)(B)(ii); 1395l(q)(2)(B)(i); 1395m(a)(11)(A),
(c)(4)(C); 1395w-2(b)(2)(A); 1395w-4(g)(1), (g)(3)(B),
(g)(4)(B)(ii); 1395nn(g)(5); 1395ss(a)(2), (p)(8), (p)(9)(C),
(q)(5)(C), (r)(6)(A), (s)(3), (t)(2); 1395bbb(f)(2)(A);
1396r(h)(3)(C)(ii); 1396r-8(b)(3)(B), (C)(ii); 1396t(j)(2)(C);
1396u(h)(2) |
42 CFR part 1003. |
| 7. Appeals of
exclusions from Medicare and State health care programs and/or
other programs under the Social Security Act |
42 U.S.C. 1395l(q)(2)(B)(ii);
1395m(a)(11)(A), (c)(5)(C); 1395w-4(g)(1), (g)(3)(B),
(g)(4)(B)(ii) |
42 CFR part 498; 42 CFR
1001.107. |
| Food
and Drug Administration |
| 1. Proceedings to
withdraw approval of new drug applications |
21 U.S.C. 355(e) |
21 CFR part 12; 21 CFR
314.200. |
| 2. Proceedings to
withdraw approval of new animal drug applications and medicated
feed applications |
21 U.S.C. 360b(e), (m) |
21 CFR part 12; 21 CFR part
514, Subpart B. |
| 3. Proceedings to
withdraw approval of medical device premarket approval
applications |
21 U.S.C. 306e(e), (g) |
21 CFR part 12. |
|
Office for Civil Rights |
| 1. Proceedings to
enforce Title VI of the Civil Rights Act of 1964, which prohibits
discrimination on the basis of race, color or national origin by
recipients of Federal financial assistance |
42 U.S.C. 2000d-1 |
45 CFR 80.9. |
| 2. Proceedings to
enforce section 504 of the Rehabilitation Act of 1973, which
prohibits discrimination on the basis of handicap by recipients of
Federal financial assistance |
29 U.S.C. 794a; 42 U.S.C.
2000d-1 |
45 CFR 84.61. |
| 3. Proceedings to
enforce the Age Discrimination Act of 1975, which prohibits
discrimination on the basis of age by recipients of Federal
financial assistance |
42 U.S.C. 6104(a) |
45 CFR 91.47. |
| 4. Proceedings to
enforce Title IX of the Education Amendments of 1972, which
prohibits discrimination on the basis of sex in certain education
programs by recipients of Federal financial assistance |
20 U.S.C. 1682 |
45 CFR 86.71. |