Revision of reopened decision.

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Standards and Certification
  6. 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
  7. Reopening of Decisions Made by Administrative Law Judges or the Departmental Appeals Board
  8. Revision of reopened decision.

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§ 498.102 Revision of reopened decision.

(a) Revision based on new evidence. If a reopened decision is to be revised on the basis of new evidence that was not included in the record of that decision, the ALJ or the Departmental Appeals Board -

(1) Notifies the parties of the proposed revision; and

(2) Unless the parties waive their right to hearing or appearance -

(i) Grants a hearing in the case of an ALJ revision; and

(ii) Grants opportunity to appear in the case of a Board revision.

(b) Basis for revised decision and right to review.

(1) If a revised decision is necessary, the ALJ or the Departmental Appeals Board, as appropriate, renders it on the basis of the entire record.

(2) If the decision is revised by an ALJ, the Departmental Appeals Board may review that revised decision at the request of either party or on its own motion.


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