[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: 42CFR498.88]



[Page 1102-1103]

 

                         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 E_Departmental Appeals Board Review

 

Sec. 498.88  Decision or remand by the Departmental Appeals Board.



    (a) When the Departmental Appeals Board reviews an ALJ's decision or 

order of dismissal, or receives a case remanded by a court, the Board 

may either issue a decision or remand the case to an ALJ for a hearing 

and decision or a recommended decision for final decision by the Board.

    (b) In a remanded case, the ALJ initiates additional proceedings and 

takes other actions as directed by the Board in its order of remand, and 

may take other action not inconsistent with that order.



[[Page 1103]]



    (c) Upon completion of all action called for by the remand order and 

any other consistent action, the ALJ promptly makes a decision or, as 

specified by the Board, certifies the case to the Board with a 

recommended decision.

    (d) The parties have 20 days from the date of a notice of a 

recommended decision to submit to the Board any exception, objection, or 

comment on the findings of fact, conclusions of law, and recommended 

decision.

    (e) After the 20-day period, the Board issues its decision adopting, 

modifying or rejecting the ALJ's recommended decision.

    (f) If the Board does not remand the case to an ALJ, the following 

rules apply:

    (1) The Board's decision--

    (i) Is based upon the evidence in the hearing record and any further 

evidence that the Board receives during its review;

    (ii) Is in writing and contains separate numbered findings of fact 

and conclusions of law; and

    (iii) May modify, affirm, or reverse the ALJ's decision.

    (2) A copy of the Board's decision is mailed to each party.