1. LawStack
  2. Title 42 - Public Health
  3. Chapter IV - CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
  4. Subchapter B - MEDICARE PROGRAM
  5. Part 426 - REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS
  6. Subpart D - Review of an LCD
  7. 42 CFR § 426.486
42 CFR § 426.486
Prohibited provisions of a Board decision
June 11, 2020
CFR

A Board decision must not do any of the following:

(a) Order CMS or its contractors to add any language to a provision or provisions of an LCD.

(b) Order CMS or its contractors to pay a specific claim.

(c) Set a time limit to establish a new or revised LCD.

(d) Review or evaluate an LCD other than the LCD named in the ALJ's decision.

(e) Include a requirement for CMS or its contractors that specifies payment, coding, or system changes for an LCD or deadlines for implementing these changes.

(f) Order CMS or its contractors to implement an LCD in a particular manner.

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§ 426.484 Mandatory provisions of a Board decision
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§ 426.487 Board's record on appeal of an ALJ's decision

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