CFR > Title 42 - Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM (parts 405 to 426) > PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED > SUBPART H—Appeals Under the Medicare Part B Program (§405.801 to §405.877) > 405.855—ALJ hearing.

405.855—ALJ hearing.

(a) Right to hearing. A party to the carrier hearing has a right to a hearing before an ALJ if—
(1) The party files a written request for an ALJ hearing within 60 days after receipt of the notice of the carrier hearing decision; and
(2) The amount remaining in controversy is $500 or more.
(b) Place of filing hearing request. The request for an ALJ hearing must be made in writing and filed with the carrier that issued the decision, a Social Security office, or, in the case of a qualified railroad retirement beneficiary, an office of the Railroad Retirement Board.
(c) Effect of ALJ hearing decision. (1) An ALJ's decision is binding on all parties to the hearing unless—
(i) The DAB reviews the ALJ decision;
(ii) The DAB does not review the ALJ decision, and the party requests judicial review;
(iii) The decision is revised by the DAB or an ALJ in accordance with the provisions of § 405.750 of this chapter; or
(iv) The expedited appeals process is used.
[62 FR 25854, May 12, 1997]