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 423—VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT > SUBPART U—Reopening, ALJ Hearings, MAC review, and Judicial Review (§423.1968 to §423.2140) > 423.2048—The effect of an ALJ's decision.

423.2048—The effect of an ALJ's decision.

The decision of the ALJ is binding unless—
(a) An enrollee requests a review of the decision by the MAC within the stated time period or the MAC reviews the decision issued by an ALJ under the procedures set forth in § 423.2110, and the MAC issues a final decision or remand order;
(b) The decision is reopened and revised by an ALJ or the MAC under the procedures explained in § 423.1980 ;
(c) The expedited access to judicial review process at § 423.1990 is used;
(d) The ALJ's decision is a recommended decision directed to the MAC and the MAC issues a decision; or
(e) In a case remanded by a Federal District Court, the MAC assumes jurisdiction under the procedures in § 423.2138 and the MAC issues a decision.