[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR498.83]



[Page 1109]

 

                         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 

 

               Subpart E_Departmental Appeals Board Review

 

Sec.  498.83  Departmental Appeals Board action on request for review.



    (a) Request by CMS or the OIG. The Departmental Appeals Board may 

dismiss, deny, or grant a request made by CMS or the OIG for review of 

an ALJ decision or dismissal.

    (b) Request by the affected party. The Board will grant the affected 

party's request for review unless it dismisses the request for one of 

the following reasons:

    (1) The affected party requests dismissal of its request for review.

    (2) The affected party did not file timely or show good cause for 

late filing.

    (3) The affected party does not have a right to review.

    (4) A previous determination or decision, based on the same facts 

and law, and regarding the same issue, has become final through judicial 

affirmance or because the affected party failed to timely request 

reconsideration, hearing, Board review, or judicial review, as 

appropriate.

    (c) Effect of dismissal. The dismissal of a request for Departmental 

Appeals Board review is binding and not subject to further review.

    (d) Review panel. If the Board grants a request for review of the 

ALJ's decision, the review will be conducted by a panel of at least two 

members of the Board, designated by the Chairperson or Deputy 

Chairperson, and one individual designated by the Secretary from the U.S 

Public Health Service.