§426.455. Prohibited provisions of an ALJ's decision.
42 C.F.R. § 426.455
An ALJ's decision may not do any of the following:
Order CMS or its contractors to add any language to a provision or provisions of an LCD.
Order CMS or its contractors to pay a specific claim.
Set a time limit for CMS or its contractors to establish a new or revised LCD.
Review or evaluate an LCD other than the LCD under review.
Include a requirement for CMS or its contractors that specifies payment, coding, or systems changes for an LCD, or deadlines for implementing these types of changes.
Order or address how a contractor(s) must implement an LCD.
Notes, amendments, and revision history
Authority
Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh)
Source
Source: 68 FR 63716, Nov. 7, 2003, unless otherwise noted.