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Code of Federal Regulations (Last Updated: April 5, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B - Medicare Program |
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Part 426 - Review of National Coverage Determinations and Local Coverage Determinations |
| Subpart A - General Provisions |
| § 426.100 - Basis and scope. |
| § 426.110 - Definitions. |
| § 426.120 - Calculation of deadlines. |
| § 426.130 - Party submissions. |
| Subpart B - XXX |
| Subpart C - General Provisions for the Review of LCDs and NCDs |
| § 426.300 - Review of LCDs, NCDs, and deemed NCDs. |
| § 426.310 - LCD and NCD reviews and individual claim appeals. |
| § 426.320 - Who may challenge an LCD or NCD. |
| § 426.325 - What may be challenged. |
| § 426.330 - Burden of proof. |
| § 426.340 - Procedures for review of new evidence. |
| Subpart D - Review of an LCD |
| § 426.400 - Procedure for filing an acceptable complaint concerning a provision (or provisions) of an LCD. |
| § 426.403 - Submitting new evidence once an acceptable complaint is filed. |
| § 426.405 - Authority of the ALJ. |
| § 426.406 - Ex parte contacts. |
| § 426.410 - Docketing and evaluating the acceptability of LCD complaints. |
| § 426.415 - CMS' role in the LCD review. |
| § 426.416 - Role of Medicare Managed Care Organizations (MCOs) and State agencies in the LCD review. |
| § 426.417 - Contractor's statement regarding new evidence. |
| § 426.418 - LCD record furnished to aggrieved party. |
| § 426.419 - LCD record furnished to the ALJ. |
| § 426.420 - Retiring or revising an LCD under review. |
| § 426.423 - Withdrawing a complaint regarding an LCD under review. |
| § 426.425 - LCD review. |
| § 426.431 - ALJ's review of the LCD to apply the reasonableness standard. |
| § 426.432 - Discovery. |
| § 426.435 - Subpoenas. |
| § 426.440 - Evidence. |
| § 426.444 - Dismissals for cause. |
| § 426.445 - Witness fees. |
| § 426.446 - Record of hearing. |
| § 426.447 - Issuance and notification of an ALJ's decision. |
| § 426.450 - Mandatory provisions of an ALJ's decision. |
| § 426.455 - Prohibited provisions of an ALJ's decision. |
| § 426.457 - Optional provisions of an ALJ's decision. |
| § 426.458 - ALJ's LCD review record. |
| § 426.460 - Effect of an ALJ's decision. |
| § 426.462 - Notice of an ALJ's decision. |
| § 426.463 - Future new or revised LCDs. |
| § 426.465 - Appealing part or all of an ALJ's decision. |
| § 426.468 - Decision to not appeal an ALJ's decision. |
| § 426.470 - Board's role in docketing and evaluating the acceptability of appeals of ALJ decisions. |
| § 426.476 - Board review of an ALJ's decision. |
| § 426.478 - Retiring or revising an LCD during the Board's review of an ALJ's decision. |
| § 426.480 - Withdrawing an appeal of an ALJ's decision. |
| § 426.482 - Issuance and notification of a Board decision. |
| § 426.484 - Mandatory provisions of a Board decision. |
| § 426.486 - Prohibited provisions of a Board decision. |
| § 426.487 - Board's record on appeal of an ALJ's decision. |
| § 426.488 - Effect of a Board decision. |
| § 426.489 - Board remands. |
| § 426.490 - Board decision. |
| Subpart E - Review of an NCD |
| § 426.500 - Procedure for filing an acceptable complaint concerning a provision (or provisions) of an NCD. |
| § 426.503 - Submitting new evidence once an acceptable complaint has been filed. |
| § 426.505 - Authority of the Board. |
| § 426.506 - Ex parte contacts. |
| § 426.510 - Docketing and evaluating the acceptability of NCD complaints. |
| § 426.513 - Participation as amicus curiae. |
| § 426.515 - CMS' role in making the NCD record available. |
| § 426.516 - Role of Medicare Managed Care Organizations (MCOs) and State agencies in the NCD review process. |
| § 426.517 - CMS' statement regarding new evidence. |
| § 426.518 - NCD record furnished to the aggrieved party. |
| § 426.519 - NCD record furnished to the Board. |
| § 426.520 - Withdrawing an NCD under review or issuing a revised or reconsidered NCD. |
| § 426.523 - Withdrawing a complaint regarding an NCD under review. |
| § 426.525 - NCD review. |
| § 426.531 - Board's review of the NCD to apply the reasonableness standard. |
| § 426.532 - Discovery. |
| § 426.535 - Subpoenas. |
| § 426.540 - Evidence. |
| § 426.544 - Dismissals for cause. |
| § 426.545 - Witness fees. |
| § 426.546 - Record of hearing. |
| § 426.547 - Issuance, notification, and posting of a Board's decision. |
| § 426.550 - Mandatory provisions of the Board's decision. |
| § 426.555 - Prohibited provisions of the Board's decision. |
| § 426.557 - Optional provisions of the Board's decision. |
| § 426.560 - Effect of the Board's decision. |
| § 426.562 - Notice of the Board's decision. |
| § 426.563 - Future new or revised or reconsidered NCDs. |
| § 426.565 - Board's role in making an LCD or NCD review record available. |
| § 426.566 - Board decision. |
| § 426.587 - Record for appeal of a Board NCD decision. |