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Title 42: Public Health
CHAPTER IV: CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)
SUBCHAPTER B: MEDICARE PROGRAM
PART 426: REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS
Subpart D: Review of an LCD
426.486 - Prohibited provisions of a Board decision.
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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