---
kind: "section"
citation: "42 C.F.R. § 405.1002"
title: "42"
number: "405.1002"
heading: "Right to an ALJ hearing."
url: "https://uscodex.org/cfr/42/405.1002"
---

# §405.1002. Right to an ALJ hearing.

- (a) **A party to a QIC reconsideration has a right to a hearing before an ALJ if—**
  - (1) The party files a written request for an ALJ hearing within 60 calendar days after receipt of the notice of the QIC's reconsideration.
  - (2) The party meets the amount in controversy requirements of [§ 405.1006](/cfr/42/405.1006.md).
  - (3) For purposes of this section, the date of receipt of the reconsideration is presumed to be 5 calendar days after the date of the reconsideration, unless there is evidence to the contrary.
  - (4) For purposes of meeting the 60 calendar day filing deadline, the request is considered as filed on the date it is received by the office specified in the QIC's reconsideration.
- (b) A party who files a timely appeal before a QIC and whose appeal continues to be pending before a QIC at the end of the period described in [§ 405.970](/cfr/42/405.970.md) has a right to a hearing before an ALJ if—
  - (1) The party files a written request with the QIC to escalate the appeal for a hearing before an ALJ after the period described in § [405.970(a)](/cfr/42/405.970.md?p=a) and [(b)](/cfr/42/405.970.md?p=b) has expired and the party files the request in accordance with [§ 405.970(d)](/cfr/42/405.970.md?p=d);
  - (2) The QIC does not issue a decision or dismissal order within 5 calendar days of receiving the request for escalation in accordance with [§ 405.970(e)(2)](/cfr/42/405.970.md?p=e-2); and
  - (3) The party has an amount remaining in controversy specified in [§ 405.1006](/cfr/42/405.1006.md).

## Notes

### Amendments

[70 FR 11472, Mar. 8, 2005, as amended at 70 FR 37703, June 30, 2005; 74 FR 65335, Dec. 9, 2009; 82 FR 5109, Jan. 17, 2017]

### Source

Source: 70 FR 11472, Mar. 8, 2005, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 263a, 405(a), 1302, 1320b-12, 1395x, 1395y(a), 1395ff, 1395hh, 1395kk, 1395rr, and 1395ww(k).

### Amendments

[70 FR 11472, Mar. 8, 2005, as amended at 70 FR 37703, June 30, 2005; 74 FR 65335, Dec. 9, 2009; 82 FR 5109, Jan. 17, 2017]