C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED › Subpart I—Determinations, Redeterminations, Reconsiderations, and Appeals Under Original Medicare (Part A and Part B)

42 C.F.R. § 405.1054

Effect of dismissal of a request for a hearing or request for review of QIC dismissal

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(a) The dismissal of a request for a hearing is binding, unless it is vacated by the Council under § 405.1108(b), or vacated by the ALJ or attorney adjudicator under § 405.1052(e).

(b) The dismissal of a request for review of a QIC dismissal of a request for reconsideration is binding and not subject to further review unless it is vacated by the ALJ or attorney adjudicator under § 405.1052(e).

[82 FR 5120, Jan. 17, 2017]
Notes of Decisions
Cited in 2 cases (2 in the last 5 years), 2021–2022 · leading case: Henry v. Azar (D.D.C. 2021).
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Henry v. Azar (D.D.C. 2021). · cites it 6× “Instead, he contends that under 42 C.F.R. § 405.1054 (b), an ALJ’s “dismissal of a request for review of a QIC dismissal of a request for reconsideration is binding and not subject to further review” by the Medicare Appeals Council.”
First United Methodist Church v. Becerra (D. Neb. 2022). · cites it 3× “Pursuant to 42 C.F.R. § 405.1054 , “[t]he dismissal of a request for review of a QIC dismissal of a request for reconsideration is binding and not subject to further review unless it is vacated by the ALJ or attorney adjudicator under § 405.”
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