{"data":{"id":"us/42-cfr-426.455","jurisdiction":"us","citation":"42 CFR 426.455","heading":"Prohibited provisions of an ALJ's decision.","body":"An ALJ's decision may not do any of the following:\n(a) Order CMS or its contractors to add any language to a provision or provisions of an LCD.\n(b) Order CMS or its contractors to pay a specific claim.\n(c) Set a time limit for CMS or its contractors to establish a new or revised LCD.\n(d) Review or evaluate an LCD other than the LCD under review.\n(e) Include a requirement for CMS or its contractors that specifies payment, coding, or systems changes for an LCD, or deadlines for implementing these types of changes.\n(f) Order or address how a contractor(s) must implement an LCD.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 426—REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS","Subpart D—Review of an LCD"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"a86b11802f5c8ccf91e3958487b3c12cc1d8b56099a48a8a51d7566a1020fc53","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-426.450","next":"us/42-cfr-426.457"},"notice":"GroundRules: Original legal text. Not legal advice."}