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 R—Provider Reimbursement Determinations and Appeals

42 C.F.R. § 405.1817

Hearing officer or panel of hearing officers authorized to conduct contractor hearing; disqualification of officers

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The contractor hearing provided for in § 405.1809 shall be conducted by a hearing officer or panel of hearing officers designated by the contractor. Such hearing officer or officers shall be persons knowledgeable in the field of health care reimbursement. The hearing officer or officers shall not have had any direct responsibility for the program reimbursement determination with respect to which a request for hearing is filed; no hearing officer (or officers) shall conduct a hearing in a case in which he is prejudiced or partial with respect to any party, or where he has any interest in the matter pending for determination before him. Notice of any objection which a party may have with respect to a hearing officer shall be presented in writing to such officer by the objecting party at the party's earliest opportunity. The hearing officer shall consider the objection and shall, at his discretion, either proceed in the conduct of the hearing or withdraw. If the hearing officer does not withdraw, the objecting party may, after the hearing, present his objections to an executive official of the contractor, who shall rule promptly on the objection.

Notes of Decisions
Cited in 2 cases, 1986–2019 · leading case: Cambridge Hosp. Ass'n, Inc. v. Bowen, 629 F. Supp. 612 (D. Minnesota 1986).
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Cambridge Hosp. Ass'n, Inc. v. Bowen, 629 F. Supp. 612 (D. Minnesota 1986). “42 C.F.R. §§ 405.1817 , .1875. In the absence of a PRRB hearing, plaintiffs have failed to exhaust their administrative remedies, and there is no "final decision" of the PRRB presented to the Court for review.”
Rocky Mountain Health Maint. Org., Inc. v. Price (D.D.C. 2019). · cites it 2× “” 42 C.F.R. § 405.1817 (2007). CMS officials likewise do not conduct intermediary hearings today.”
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