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Title 42 → Chapter IV → Subchapter G → Part 498

TITLE 42—Public Health

CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)

SUBCHAPTER G—STANDARDS AND CERTIFICATION

PART 498—APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN THE MEDICARE PROGRAM AND FOR DETERMINATIONS THAT AFFECT THE PARTICIPATION OF ICFs/IID AND CERTAIN NFs IN THE MEDICAID PROGRAM

rule

Subpart A—GENERAL PROVISIONS

§498.1
Statutory basis.
§498.2
Definitions.
§498.3
Scope and applicability.
§498.4
NFs subject to appeals process in part 498.
§498.5
Appeal rights.
§498.10
Appointment of representatives.
§498.11
Authority of representatives.
§498.13
Fees for services of representatives.
§498.15
Charge for transcripts.
§498.17
Filing of briefs with the ALJ or Departmental Appeals Board, and opportunity for rebuttal.
rule

Subpart B—INITIAL, RECONSIDERED, AND REVISED DETERMINATIONS

§498.20
Notice and effect of initial determinations.
§498.22
Reconsideration.
§498.23
Withdrawal of request for reconsideration.
§498.24
Reconsidered determination.
§498.25
Notice and effect of reconsidered determination.
rule

Subpart C—REOPENING OF INITIAL OR RECONSIDERED DETERMINATIONS

§498.30
Limitation on reopening.
§498.32
Notice and effect of reopening and revision.
rule

Subpart D—HEARINGS

§498.40
Request for hearing.
§498.42
Parties to the hearing.
§498.44
Designation of hearing official.
§498.45
Disqualification of Administrative Law Judge.
§498.47
Prehearing conference.
§498.48
Notice of prehearing conference.
§498.49
Conduct of prehearing conference.
§498.50
Record, order, and effect of prehearing conference.
§498.52
Time and place of hearing.
§498.53
Change in time and place of hearing.
§498.54
Joint hearings.
§498.56
Hearing on new issues.
§498.58
Subpoenas.
§498.60
Conduct of hearing.
§498.61
Evidence.
§498.62
Witnesses.
§498.63
Oral and written summation.
§498.64
Record of hearing.
§498.66
Waiver of right to appear and present evidence.
§498.68
Dismissal of request for hearing.
§498.69
Dismissal for abandonment.
§498.70
Dismissal for cause.
§498.71
Notice and effect of dismissal and right to request review.
§498.72
Vacating a dismissal of request for hearing.
§498.74
Administrative Law Judge's decision.
§498.76
Removal of hearing to Departmental Appeals Board.
§498.78
Remand by the Administrative Law Judge.
§498.79
Timeframes for deciding an enrollment appeal before an ALJ.
rule

Subpart E—DEPARTMENTAL APPEALS BOARD REVIEW

§498.80
Right to request Departmental Appeals Board review of Administrative Law Judge's decision or dismissal.
§498.82
Request for Departmental Appeals Board review.
§498.83
Departmental Appeals Board action on request for review.
§498.85
Procedures before the Departmental Appeals Board on review.
§498.86
Evidence admissible on review.
§498.88
Decision or remand by the Departmental Appeals Board.
§498.90
Effect of Departmental Appeals Board decision.
§498.95
Extension of time for seeking judicial review.
rule

Subpart F—REOPENING OF DECISIONS MADE BY ADMINISTRATIVE LAW JUDGES OR THE DEPARTMENTAL APPEALS BOARD

§498.100
Basis, timing, and authority for reopening an ALJ or Board decision.
§498.102
Revision of reopened decision.
§498.103
Notice and effect of revised decision.

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