Part 498 - Appeals Procedures for Determinations That Affect Participation in the Medicare Program and for Determinations That Affect the Participation of Icfs/IID and Certain Nfs in the Medicaid Program


Subpart A - General Provisions
§ 498.1 - Statutory basis.
§ 498.2 - Definitions.
§ 498.3 - Scope and applicability.
§ 498.4 - NFs subject to appeals process in part 498.
§ 498.5 - Appeal rights.
§ 498.10 - Appointment of representatives.
§ 498.11 - Authority of representatives.
§ 498.13 - Fees for services of representatives.
§ 498.15 - Charge for transcripts.
§ 498.17 - Filing of briefs with the ALJ or Departmental Appeals Board, and opportunity for rebuttal.
Subpart B - Initial, Reconsidered, and Revised Determinations
§ 498.20 - Notice and effect of initial determinations.
§ 498.22 - Reconsideration.
§ 498.23 - Withdrawal of request for reconsideration.
§ 498.24 - Reconsidered determination.
§ 498.25 - Notice and effect of reconsidered determination.
Subpart C - Reopening of Initial or Reconsidered Determinations
§ 498.30 - Limitation on reopening.
§ 498.32 - Notice and effect of reopening and revision.
Subpart D - Hearings
§ 498.40 - Request for hearing.
§ 498.42 - Parties to the hearing.
§ 498.44 - Designation of hearing official.
§ 498.45 - Disqualification of Administrative Law Judge.
§ 498.47 - Prehearing conference.
§ 498.48 - Notice of prehearing conference.
§ 498.49 - Conduct of prehearing conference.
§ 498.50 - Record, order, and effect of prehearing conference.
§ 498.52 - Time and place of hearing.
§ 498.53 - Change in time and place of hearing.
§ 498.54 - Joint hearings.
§ 498.56 - Hearing on new issues.
§ 498.58 - Subpoenas.
§ 498.60 - Conduct of hearing.
§ 498.61 - Evidence.
§ 498.62 - Witnesses.
§ 498.63 - Oral and written summation.
§ 498.64 - Record of hearing.
§ 498.66 - Waiver of right to appear and present evidence.
§ 498.68 - Dismissal of request for hearing.
§ 498.69 - Dismissal for abandonment.
§ 498.70 - Dismissal for cause.
§ 498.71 - Notice and effect of dismissal and right to request review.
§ 498.72 - Vacating a dismissal of request for hearing.
§ 498.74 - Administrative Law Judge's decision.
§ 498.76 - Removal of hearing to Departmental Appeals Board.
§ 498.78 - Remand by the Administrative Law Judge.
§ 498.79 - Timeframes for deciding an enrollment appeal before an ALJ.
Subpart E - Departmental Appeals Board Review
§ 498.80 - Right to request Departmental Appeals Board review of Administrative Law Judge's decision or dismissal.
§ 498.82 - Request for Departmental Appeals Board review.
§ 498.83 - Departmental Appeals Board action on request for review.
§ 498.85 - Procedures before the Departmental Appeals Board on review.
§ 498.86 - Evidence admissible on review.
§ 498.88 - Decision or remand by the Departmental Appeals Board.
§ 498.90 - Effect of Departmental Appeals Board decision.
§ 498.95 - Extension of time for seeking judicial review.
Subpart F - Reopening of Decisions Made by Administrative Law Judges or the Departmental Appeals Board
§ 498.100 - Basis, timing, and authority for reopening an ALJ or Board decision.
§ 498.102 - Revision of reopened decision.
§ 498.103 - Notice and effect of revised decision.