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