[Code of Federal Regulations] [Title 42, Volume 3] [Revised as of October 1, 2005] From the U.S. Government Printing Office via GPO Access [CITE: 42CFR498.74] [Page 1101] TITLE 42--PUBLIC HEALTH CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PART 498_APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN THE MEDICARE PROGRAM AND FOR DETERMINATIONS THAT AFFECT THE PARTICIPATION OF ICFs/MR AND CERTAIN NFs IN THE MEDICAID PROGRAM--Table of Contents Subpart D_Hearings Sec. 498.74 Administrative Law Judge's decision. (a) Timing, basis and content. As soon as practical after the close of the hearing, the ALJ issues a written decision in the case. The decision is based on the evidence of record and contains separate numbered findings of fact and conclusions of law. (b) Notice and effect. A copy of the decision is mailed to the parties and is binding on them unless-- (1) A party requests review by the Departmental Appeals Board within the time period specified in Sec. 498.82, and the Board reviews the case; (2) The Departmental Appeals Board denies the request for review and the party seeks judicial review by filing an action in a United States District Court or, in the case of a civil money penalty, in a United States Court of Appeals; (3) The decision is revised by an ALJ or the Departmental Appeals Board; or (4) The decision is a recommended decision directed to the Board. [52 FR 22446, June 12, 1987, as amended at 61 FR 32351, June 24, 1996]