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) |
Applicability of Medicare Coverage Policies |
§ 405.1064 - ALJ decisions involving statistical samples.
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§ 405.1064 ALJ decisions involving statistical samples.
When an appeal from the QIC involves an overpayment issue and the QIC used a statistical sample in reaching its reconsideration, the ALJ must base his or her decision on a review of the entire statistical sample used by the QIC.