42 CFR Part 426
PART 426—REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS
- PART 426—REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS
- Chapter IV—Centers for Medicare & Medicaid Services, Department of Health and Human Services › Subchapter B—Medicare Program
- Subpart A—General Provisions
- § 426.100 Basis and scope.
- § 426.110 Definitions.
- § 426.120 Calculation of deadlines.
- § 426.130 Party submissions.
- Subpart B [Reserved]
- Subpart C—General Provisions for the Review of LCDs and NCDs
- § 426.300 Review of LCDs, NCDs, and deemed NCDs.
- § 426.310 LCD and NCD reviews and individual claim appeals.
- § 426.320 Who may challenge an LCD or NCD.
- § 426.325 What may be challenged.
- § 426.330 Burden of proof.
- § 426.340 Procedures for review of new evidence.
- Subpart D—Review of an LCD
- § 426.400 Procedure for filing an acceptable complaint concerning a provision (or provisions) of an LCD.
- § 426.403 Submitting new evidence once an acceptable complaint is filed.
- § 426.405 Authority of the ALJ.
- § 426.406 Ex parte contacts.
- § 426.410 Docketing and evaluating the acceptability of LCD complaints.
- § 426.415 CMS' role in the LCD review.
- § 426.416 Role of Medicare Managed Care Organizations (MCOs) and State agencies in the LCD review.
- § 426.417 Contractor's statement regarding new evidence.
- § 426.418 LCD record furnished to aggrieved party.
- § 426.419 LCD record furnished to the ALJ.
- § 426.420 Retiring or revising an LCD under review.
- § 426.423 Withdrawing a complaint regarding an LCD under review.
- § 426.425 LCD review.
- § 426.431 ALJ's review of the LCD to apply the reasonableness standard.
- § 426.432 Discovery.
- § 426.435 Subpoenas.
- § 426.440 Evidence.
- § 426.444 Dismissals for cause.
- § 426.445 Witness fees.
- § 426.446 Record of hearing.
- § 426.447 Issuance and notification of an ALJ's decision.
- § 426.450 Mandatory provisions of an ALJ's decision.
- § 426.455 Prohibited provisions of an ALJ's decision.
- § 426.457 Optional provisions of an ALJ's decision.
- § 426.458 ALJ's LCD review record.
- § 426.460 Effect of an ALJ's decision.
- § 426.462 Notice of an ALJ's decision.
- § 426.463 Future new or revised LCDs.
- § 426.465 Appealing part or all of an ALJ's decision.
- § 426.468 Decision to not appeal an ALJ's decision.
- § 426.470 Board's role in docketing and evaluating the acceptability of appeals of ALJ decisions.
- § 426.476 Board review of an ALJ's decision.
- § 426.478 Retiring or revising an LCD during the Board's review of an ALJ's decision.
- § 426.480 Withdrawing an appeal of an ALJ's decision.
- § 426.482 Issuance and notification of a Board decision.
- § 426.484 Mandatory provisions of a Board decision.
- § 426.486 Prohibited provisions of a Board decision.
- § 426.487 Board's record on appeal of an ALJ's decision.
- § 426.488 Effect of a Board decision.
- § 426.489 Board remands.
- § 426.490 Board decision.
- Subpart E—Review of an NCD
- § 426.500 Procedure for filing an acceptable complaint concerning a provision (or provisions) of an NCD.
- § 426.503 Submitting new evidence once an acceptable complaint has been filed.
- § 426.505 Authority of the Board.
- § 426.506 Ex parte contacts.
- § 426.510 Docketing and evaluating the acceptability of NCD complaints.
- § 426.513 Participation as amicus curiae.
- § 426.515 CMS' role in making the NCD record available.
- § 426.516 Role of Medicare Managed Care Organizations (MCOs) and State agencies in the NCD review process.
- § 426.517 CMS' statement regarding new evidence.
- § 426.518 NCD record furnished to the aggrieved party.
- § 426.519 NCD record furnished to the Board.
- § 426.520 Withdrawing an NCD under review or issuing a revised or reconsidered NCD.
- § 426.523 Withdrawing a complaint regarding an NCD under review.
- § 426.525 NCD review.
- § 426.531 Board's review of the NCD to apply the reasonableness standard.
- § 426.532 Discovery.
- § 426.535 Subpoenas.
- § 426.540 Evidence.
- § 426.544 Dismissals for cause.
- § 426.545 Witness fees.
- § 426.546 Record of hearing.
- § 426.547 Issuance, notification, and posting of a Board's decision.
- § 426.550 Mandatory provisions of the Board's decision.
- § 426.555 Prohibited provisions of the Board's decision.
- § 426.557 Optional provisions of the Board's decision.
- § 426.560 Effect of the Board's decision.
- § 426.562 Notice of the Board's decision.
- § 426.563 Future new or revised or reconsidered NCDs.
- § 426.565 Board's role in making an LCD or NCD review record available.
- § 426.566 Board decision.
- § 426.587 Record for appeal of a Board NCD decision.
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