Code of Federal Regulations (Last Updated: May 6, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter B - Medicare Program |
Part 405 - Federal Health Insurance for the Aged and Disabled |
Subpart I - Determinations, Redeterminations, Reconsiderations, and Appeals Under Original Medicare (Part A and Part B) |
ALJ Hearings |
§ 405.1044 - Consolidated proceedings.
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§ 405.1044 Consolidated hearing before an ALJ.
proceedings.
b(a) Consolidated hearing.
another request for hearing or hearings(1) A consolidated hearing may be held if one or more of the issues to be considered at the hearing are the same issues that are involved in
one or more other appeals pending before the same ALJ.
(
requests2) It is within the discretion of the ALJ to grant or deny an appellant's request for consolidation. In considering an appellant's request, the ALJ may consider factors such as whether the claims at issue may be more efficiently decided if the
are combinedappeals are consolidated for hearing
the. In considering the appellant's request for consolidation, the ALJ must take into account
caseany adjudication deadlines for each
casesappeal and may require an appellant to waive the adjudication deadline associated with one or more
cappeals if consolidation otherwise prevents the ALJ from deciding all of the appeals at issue within their respective deadlines.
(
cases3) The ALJ may also propose on his or her own motion to consolidate two or more
dappeals in one hearing for administrative efficiency, but may not require an appellant to waive the adjudication deadline for any of the consolidated cases.
(
Before consolidating4)
, the ALJ must notify CMS of his or her intention to do so, and CMS may then elect to participate in the consolidated hearing, as a party, by sending written notice to the ALJ within 10 calendar days after receipt of the ALJ's notice of the consolidation. (e)Notice of a consolidated hearing
must be included in the notice of hearing issued in accordance with §§ 405.1020 and 405.1022.
either a(b) Consolidated or separate decision and record.
(1) If the ALJ decides to hold a consolidated hearing, he or she may make
claim. The ALJ ensureseither—
(i) A consolidated decision and record; or
(ii) A separate decision and record on each appeal.
(2) If a separate decision and record on each
claimsappeal is made, the ALJ is responsible for making sure that any evidence that is common to all
isappeals and material to the common issue to be decided
the consolidated record or, and audio recordings of any conferences that were conducted and the consolidated hearing are included in
[70 FR 11472, Mar. 8, 2005, as amended at 74 FR 65336, Dec. 9, 2009each individual administrative record, as applicable.
(3) If a hearing will not be conducted for multiple appeals that are before the same ALJ or attorney adjudicator, and the appeals involve one or more of the same issues, the ALJ or attorney adjudicator may make a consolidated decision and record at the request of the appellant or on the ALJ's or attorney adjudicator's own motion.
(c) Limitation on consolidated proceedings. Consolidated proceedings may only be conducted for appeals filed by the same appellant, unless multiple appellants aggregated claims to meet the amount in controversy requirement in accordance with § 405.1006 and the beneficiaries whose claims are at issue have all authorized disclosure of their protected information to the other parties and any participants.
[82 FR 5118, Jan. 17, 2017]