42 CFR §405.1809
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Hearings. Each contractor must establish and maintain written procedures for contractor hearings, in accordance with the regulations in this subpart, for resolving issues that may arise between the contractor and a provider concerning the amount of reasonable cost reimbursement, or prospective payment due the provider (except as provided in § 405.1804) under the Medicare program. The procedures must provide for a hearing on the contractor determination contained in the notice of program reimbursement (§ 405.1803), if the provider files a timely request for a hearing.
- (b)Amount in controversy. In order for a contractor to grant a hearing, the following dates and amounts in controversy apply: