(a) Right to a hearing. The following parties are entitled to a hearing:

(1) A contract applicant that has been determined to be unqualified to enter into a contract with CMS under Part D of Title XVIII of the Act in accordance with §423.502 and §423.503 of this part.

(2) A Part D sponsor whose contract has been terminated in accordance with §423.509 of this part.

(3) A Part D sponsor whose contract has not been renewed in accordance with §423.507 of this part.

(4) A Part D sponsor who has had an intermediate sanction imposed in accordance with §423.752(a) through (b).

(b) Burden of proof, standard of proof, and standard of review at hearing.

(1) During a hearing to review a contract determination as described at §423.641(a) of this subpart, the applicant has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of §423.502 and §423.503 of this part.

(2) During a hearing to review a contract determination as described at §423.641(b) of this part, the Part D plan sponsor has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of §423.507 of this part.

(3) During a hearing to review a contract determination as described at §423.641(c) of this subpart, the Part D plan sponsor has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of §423.509 of this part.

(4) During a hearing to review the imposition of an intermediate sanction as described at §423.750 of this part, the Part D sponsor has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of §423.752 of this part.

(c) Timing of favorable decision. Notice of any decision favorable to the Part D sponsor appealing a determination that it is not qualified to enter into a contract with CMS must be issued by September 1 for the contract in question to be effective on January 1 of the following year.

[75 FR 19824, Apr. 15, 2010, as amended at 80 FR 7965, Feb. 12, 2015]