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Notes

20 C.F.R. §§ 418.1340–418.1355

4 sections in range

§418.1340. What are the rules for our administrative review process?

20 C.F.R. § 418.1340

To the extent that they are not inconsistent with the rules in this subpart for making initial determinations and reconsidered determinations, we will use the same rules for the administrative review process that we use for determinations and decisions about your rights regarding non-medical issues under title II of the Act, as described in subpart J of part 404 of this chapter. We will accept oral requests as well as the written requests required in subpart J of part 404 of this chapter for requesting administrative review of our determination. If you are dissatisfied with our reconsidered determination, you may request review in accordance with § 418.1350 for this subpart. A request for a new initial determination, described in § 418.1310, is not the same as a request for reconsideration or further administrative review.
Notes, amendments, and revision history

Authority

Authority: Secs. 702(a)(5) and 1839(i) of the Social Security Act (42 U.S.C. 902(a)(5) and 1395r(i)).

Source

Source: 71 FR 62931, Oct. 27, 2006, unless otherwise noted.

Source

Source: 70 FR 77675, Dec. 30, 2005, unless otherwise noted.

§418.1345. Is reopening of an initial or reconsidered determination made by us ever appropriate?

20 C.F.R. § 418.1345

We may reopen an initial or reconsidered determination made by us when the conditions for reopening are met as described in § 404.988 of this chapter. We will use the rules in §§ 404.987 through 404.991a of this chapter when we reopen determinations made by us.
Notes, amendments, and revision history

Authority

Authority: Secs. 702(a)(5) and 1839(i) of the Social Security Act (42 U.S.C. 902(a)(5) and 1395r(i)).

Source

Source: 71 FR 62931, Oct. 27, 2006, unless otherwise noted.

Source

Source: 70 FR 77675, Dec. 30, 2005, unless otherwise noted.

§418.1350. What are the rules for review of a reconsidered determination or an administrative law judge decision?

20 C.F.R. § 418.1350

You may request a hearing before an OMHA administrative law judge consistent with HHS' regulations at 42 CFR part 405. You may seek further review of the administrative law judge's decision by requesting MAC review and judicial review in accordance with HHS' regulations.
Notes, amendments, and revision history

Amendments

[78 FR 57260, Sept. 18, 2013]

Authority

Authority: Secs. 702(a)(5) and 1839(i) of the Social Security Act (42 U.S.C. 902(a)(5) and 1395r(i)).

Source

Source: 71 FR 62931, Oct. 27, 2006, unless otherwise noted.

Source

Source: 70 FR 77675, Dec. 30, 2005, unless otherwise noted.

Amendments

[78 FR 57260, Sept. 18, 2013]

§418.1355. What are the rules for reopening a decision by an administrative law judge of the Office of Medicare Hearings and Appeals (OMHA) or by the Medicare Appeals Council (MAC)?

20 C.F.R. § 418.1355

The rules in 42 CFR 405.980 through 405.986 govern reopenings of decisions by an administrative law judge of the OMHA and decisions by the MAC. A decision by an administrative law judge of the OMHA may be reopened by the administrative law judge or by the MAC. A decision by the MAC may be reopened only by the MAC.
Notes, amendments, and revision history

Authority

Authority: Secs. 702(a)(5) and 1839(i) of the Social Security Act (42 U.S.C. 902(a)(5) and 1395r(i)).

Source

Source: 71 FR 62931, Oct. 27, 2006, unless otherwise noted.

Source

Source: 70 FR 77675, Dec. 30, 2005, unless otherwise noted.