42 CFR 405.1867 - Scope of Board's legal authority

Cite as42 CFR 405.1867
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48 practice notes
  • Health insurance reform: Civil money penalties; investigations policies and procedures, penalties imposition, and hearings,
    • United States
    • Federal Register February 16, 2006
    • 16 Febrero 2006
    ...relied on such guidance, as is done in the regulations relating to hearings by the Provider Reimbursement Review Board (PRRB), citing to 42 CFR 405.1867. Response: The ``published guidances'', including FAQs, inform covered entities of the approach HHS is taking in the enforcement of the HI......
  • Part III
    • United States
    • Federal Register February 16, 2006
    • 16 Febrero 2006
    ...relied on such guidance, as is done in the regulations relating to hearings by the Provider Reimbursement Review Board (PRRB), citing to 42 CFR 405.1867. Response: The ``published guidances'', including FAQs, inform covered entities of the approach HHS is taking in the enforcement of the HI......
  • E. Tex. Med. Center-Athens v. Azar, Civil Action No. 17-543 (RBW)
    • United States
    • United States District Courts. United States District Court (Columbia)
    • 18 Octubre 2018
    ...table, CMS proposed to redesignate Henderson County, Texas to the CBSA for Tyler, Texas....JA 11 (footnotes omitted) (first quoting 42 C.F.R. § 405.1867 ; then quoting Kennecott Utah Copper Corp. v. U.S. Dep't of Interior, 88 F.3d 1191, 1223 (D.C. Cir. 1996) ). After examining the Proposed ......
  • Lenox Hill Hospital v. Shalala, Civil Action No. 99-CV03087SSH.
    • United States
    • United States District Courts. United States District Court (Columbia)
    • 14 Noviembre 2000
    ...they were challenging the Secretary's methodology in calculating outlier payments, and that the Board lacked authority pursuant to 42 C.F.R. § 405.1867 to set aside the challenged portions of that methodology. See A.R. 234-36. Plaintiffs subsequently requested that the Board find good cause......
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45 cases
  • E. Tex. Med. Center-Athens v. Azar, Civil Action No. 17-543 (RBW)
    • United States
    • United States District Courts. United States District Court (Columbia)
    • 18 Octubre 2018
    ...table, CMS proposed to redesignate Henderson County, Texas to the CBSA for Tyler, Texas....JA 11 (footnotes omitted) (first quoting 42 C.F.R. § 405.1867 ; then quoting Kennecott Utah Copper Corp. v. U.S. Dep't of Interior, 88 F.3d 1191, 1223 (D.C. Cir. 1996) ). After examining the Proposed ......
  • Lenox Hill Hospital v. Shalala, Civil Action No. 99-CV03087SSH.
    • United States
    • United States District Courts. United States District Court (Columbia)
    • 14 Noviembre 2000
    ...they were challenging the Secretary's methodology in calculating outlier payments, and that the Board lacked authority pursuant to 42 C.F.R. § 405.1867 to set aside the challenged portions of that methodology. See A.R. 234-36. Plaintiffs subsequently requested that the Board find good cause......
  • Mercy Hosp. of Laredo v. Heckler, No. 84-2382
    • United States
    • United States Courts of Appeals. United States Court of Appeals (5th Circuit)
    • 6 Diciembre 1985
    ...it is bound to the relevant statutory law and to the Secretary's regulations and other substantive rules. 42 U.S.C. Sec. 1395oo (e); 42 C.F.R. Sec. 405.1867. 15 Appellants point out, reasonably we think, that such a standard does not necessarily have a rational relationship to the showing w......
  • The Univ. Of Tex. M.D. Anderson Cancer Ctr. v. Sebelius, Civil Action No. RDB-08-0946.
    • United States
    • United States District Courts. United States District Court (Columbia)
    • 19 Abril 2010
    ...of new services such as the administration of new drugs. The Board is required to “afford great weight” to the manual guidelines. See 42 C.F.R. § 405.1867. As an initial matter, this Court finds that the Secretary's process is appropriately rigorous and quantitative. The regulations require......
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