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- 42 CFR 405.809 · Reinstatement of provider or supplier billing privileges following corrective action.
- 42 CFR 405.812 · Effective date for DMEPOS supplier's billing privileges.
- 42 CFR 405.815 · Submission of claims.
- 42 CFR 405.818 · Deadline for processing provider enrollment initial determinations.
- 42 CFR 405.900 · Basis and scope.
- 42 CFR 405.902 · Definitions.
- 42 CFR 405.903 · Prepayment review.
- 42 CFR 405.904 · Medicare initial determinations, redeterminations and appeals: General description.
- 42 CFR 405.906 · Parties to the initial determinations, redeterminations, reconsiderations, hearings, and reviews.
- 42 CFR 405.908 · Medicaid State agencies.
- 42 CFR 405.910 · Appointed representatives.
- 42 CFR 405.912 · Assignment of appeal rights.
- 42 CFR 405.920 · Initial determinations.
- 42 CFR 405.921 · Notice of initial determination.
- 42 CFR 405.922 · Time frame for processing initial determinations.
- 42 CFR 405.924 · Actions that are initial determinations.
- 42 CFR 405.925 · Decisions of utilization review committees.
- 42 CFR 405.926 · Actions that are not initial determinations.
- 42 CFR 405.927 · Initial determinations subject to the reopenings process.
- 42 CFR 405.928 · Effect of the initial determination.
- 42 CFR 405.929 · Post-payment review.
- 42 CFR 405.930 · Failure to respond to additional documentation request.
- 42 CFR 405.931 · Scope, basis, and definitions.
- 42 CFR 405.932 · Right to appeal a denial of Part A coverage resulting from a change in patient status.
- 42 CFR 405.934 · Reconsideration.
- 42 CFR 405.936 · Hearings before an ALJ and decisions by an ALJ or Attorney Adjudicator.
- 42 CFR 405.938 · Review by the Medicare Appeals Council and judicial review.
- 42 CFR 405.940 · Right to a redetermination.
- 42 CFR 405.942 · Time frame for filing a request for a redetermination.
- 42 CFR 405.944 · Place and method of filing a request for a redetermination.
- 42 CFR 405.946 · Evidence to be submitted with the redetermination request.
- 42 CFR 405.947 · Notice to the beneficiary of applicable plan's request for a redetermination.
- 42 CFR 405.948 · Conduct of a redetermination.
- 42 CFR 405.950 · Time frame for making a redetermination.
- 42 CFR 405.952 · Withdrawal or dismissal of a request for a redetermination.
- 42 CFR 405.954 · Redetermination.
- 42 CFR 405.956 · Notice of a redetermination.
- 42 CFR 405.958 · Effect of a redetermination.
- 42 CFR 405.960 · Right to a reconsideration.
- 42 CFR 405.962 · Timeframe for filing a request for a reconsideration.
- 42 CFR 405.964 · Place and method of filing a request for a reconsideration.
- 42 CFR 405.966 · Evidence to be submitted with the reconsideration request.
- 42 CFR 405.968 · Conduct of a reconsideration.
- 42 CFR 405.970 · Timeframe for making a reconsideration following a contractor redetermination.
- 42 CFR 405.972 · Withdrawal or dismissal of a request for reconsideration or review of a contractor's dismissal of a request for redetermination.
- 42 CFR 405.974 · Reconsideration and review of a contractor's dismissal of a request for redetermination.
- 42 CFR 405.976 · Notice of a reconsideration.
- 42 CFR 405.978 · Effect of a reconsideration.
- 42 CFR 405.980 · Reopening of initial determinations, redeterminations, reconsiderations, decisions, and reviews.
- 42 CFR 405.982 · Notice of a revised determination or decision.
- 42 CFR 405.984 · Effect of a revised determination or decision.
- 42 CFR 405.986 · Good cause for reopening.
- 42 CFR 405.990 · Expedited access to judicial review.
- 42 CFR 405.1000 · Hearing before an ALJ and decision by an ALJ or attorney adjudicator: General rule.
- 42 CFR 405.1002 · Right to an ALJ hearing.
- 42 CFR 405.1004 · Right to a review of QIC notice of dismissal.
- 42 CFR 405.1006 · Amount in controversy required for an ALJ hearing and judicial review.
- 42 CFR 405.1008 · Parties to the proceedings on a request for an ALJ hearing.
- 42 CFR 405.1010 · When CMS or its contractors may participate in the proceedings on a request for an ALJ hearing.
- 42 CFR 405.1012 · When CMS or its contractors may be a party to a hearing.
- 42 CFR 405.1014 · Request for an ALJ hearing or a review of a QIC dismissal.
- 42 CFR 405.1016 · Time frames for deciding an appeal of a QIC reconsideration or escalated request for a QIC reconsideration.
- 42 CFR 405.1018 · Submitting evidence.
- 42 CFR 405.1020 · Time and place for a hearing before an ALJ.
- 42 CFR 405.1022 · Notice of a hearing before an ALJ.
- 42 CFR 405.1024 · Objections to the issues.
- 42 CFR 405.1026 · Disqualification of the ALJ or attorney adjudicator.
- 42 CFR 405.1028 · Review of evidence submitted by parties.
- 42 CFR 405.1030 · ALJ hearing procedures.
- 42 CFR 405.1032 · Issues before an ALJ or attorney adjudicator.
- 42 CFR 405.1034 · Requesting information from the QIC.
- 42 CFR 405.1036 · Description of an ALJ hearing process.
- 42 CFR 405.1037 · Discovery.
- 42 CFR 405.1038 · Deciding a case without a hearing before an ALJ.
- 42 CFR 405.1040 · Prehearing and posthearing conferences.
- 42 CFR 405.1042 · The administrative record.
- 42 CFR 405.1044 · Consolidated proceedings.
- 42 CFR 405.1046 · Notice of an ALJ or attorney adjudicator decision.
- 42 CFR 405.1048 · The effect of an ALJ's or attorney adjudicator's decision.
- 42 CFR 405.1050 · Removal of a hearing request from OMHA to the Council.
- 42 CFR 405.1052 · Dismissal of a request for a hearing before an ALJ or request for review of a QIC dismissal.
- 42 CFR 405.1054 · Effect of dismissal of a request for a hearing or request for review of QIC dismissal.
- 42 CFR 405.1056 · Remands of requests for hearing and requests for review.
- 42 CFR 405.1058 · Effect of a remand.
- 42 CFR 405.1060 · Applicability of national coverage determinations (NCDs).
- 42 CFR 405.1062 · Applicability of local coverage determinations and other policies not binding on the ALJ or attorney adjudicator and Council.
- 42 CFR 405.1063 · Applicability of laws, regulations, CMS Rulings, and precedential decisions.
- 42 CFR 405.1100 · Medicare Appeals Council review: General.
- 42 CFR 405.1102 · Request for Council review when ALJ or attorney adjudicator issues decision or dismissal.
- 42 CFR 405.1106 · Where a request for review or escalation may be filed.
- 42 CFR 405.1108 · Council actions when request for review or escalation is filed.
- 42 CFR 405.1110 · Council reviews on its own motion.
- 42 CFR 405.1112 · Content of request for review.
- 42 CFR 405.1114 · Dismissal of request for review.
- 42 CFR 405.1116 · Effect of dismissal of request for Council review or request for hearing.
- 42 CFR 405.1118 · Obtaining evidence from the Council.
- 42 CFR 405.1120 · Filing briefs with the Council.
- 42 CFR 405.1122 · What evidence may be submitted to the Council.
- 42 CFR 405.1124 · Oral argument.
- 42 CFR 405.1126 · Case remanded by the Council.