---
kind: "section"
citation: "42 C.F.R. § 422.660"
title: "42"
number: "422.660"
heading: "Right to a hearing, burden of proof, standard of proof, and standards of review."
url: "https://uscodex.org/cfr/42/422.660"
---

# §422.660. Right to a hearing, burden of proof, standard of proof, and standards of review.

- (a) **Right to a hearing.** The following parties are entitled to a hearing:
  - (1) A contract applicant that has been determined to be unqualified to enter into a contract with CMS under Part C of Title XVIII of the Act in accordance with §§ [422.501](/cfr/42/422.501.md) and [422.502](/cfr/42/422.502.md).
  - (2) An MA organization whose contract has been terminated in accordance with [§ 422.510](/cfr/42/422.510.md).
  - (3) An MA organization whose contract has not been renewed in accordance with [§ 422.506](/cfr/42/422.506.md).
  - (4) An MA organization who has had an intermediate sanction imposed in accordance with [§ 422.752(a) through (b)](/cfr/42/422.752.md?p=a..b) of this part.
  - (5) An applicant that has been determined to be unqualified to offer a Specialized MA Plan for Special Needs Individuals.
- (b) **Burden of proof, standard of proof, and standards of review at a hearing.**
  - (1) During a hearing to review a contract determination as described at [§ 422.641(a)](/cfr/42/422.641.md?p=a) of this subpart, the applicant has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of §§ [422.501](/cfr/42/422.501.md) and [422.502](/cfr/42/422.502.md) of this part.
  - (2) During a hearing to review a contract determination as described at [§ 422.641(b)](/cfr/42/422.641.md?p=b) of this subpart, the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of [§ 422.506](/cfr/42/422.506.md) of this part.
  - (3) During a hearing to review a contract determination as described at [§ 422.641(c)](/cfr/42/422.641.md?p=c) of this subpart, the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of [§ 422.510](/cfr/42/422.510.md) of this part.
  - (4) During a hearing to review the imposition of an intermediate sanction as described at [§ 422.750](/cfr/42/422.750.md), the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of § [422.752(a)](/cfr/42/422.752.md?p=a) and [(b)](/cfr/42/422.752.md?p=b).
  - (5) During a hearing to review a determination as described at [§ 422.641(d)](/cfr/42/422.641.md?p=d) of this subpart, the applicant has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of [§§ 422.2](/cfr/42/422.2.md); 422.4(a)(1)(iv); 422.101(f); 422.107, if applicable; and 422.152(g) of this part.
- (c) **Timing of favorable decisions.** Notice of any decision favorable to the MA organization appealing a determination that it is not qualified to enter into a contract with CMS must be issued by September 1 for the contract in question to be effective on January 1 of the following year.

## Notes

### Amendments

[75 FR 19813, Apr. 15, 2010, as amended at 77 FR 22168, Apr. 12, 2012; 80 FR 7962, Feb. 12, 2015]

### Source

Source: 63 FR 35113, June 26, 1998, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302, 1306, 1395w-21 through 1395w-28, and 1395hh.

### Source

Source: 63 FR 18134, Apr. 14, 1998, unless otherwise noted.

### Amendments

[75 FR 19813, Apr. 15, 2010, as amended at 77 FR 22168, Apr. 12, 2012; 80 FR 7962, Feb. 12, 2015]