42 C.F.R. § 405.1867
Scope of Board's legal authority
In exercising its authority to conduct proceedings under this subpart, the Board must comply with all the provisions of Title XVIII of the Act and regulations issued thereunder, as well as CMS Rulings issued under the authority of the Administrator as described in § 401.108 of this subchapter. The Board shall afford great weight to interpretive rules, general statements of policy, and rules of agency organization, procedure, or practice established by CMS.
Notes of Decisions
Cited in 48
cases (5 in the last 5 years), 1980–2024 · leading case: Catholic Health Initiatives v. Sebelius, 617 F.3d 490 (D.C. Cir. 2010).
Catholic Health Initiatives v. Sebelius, 617 F.3d 490 (D.C. Cir. 2010). “42 C.F.R. § 405.1867 . *493 In a three to two decision, the Board held that the investment limitations in § 2162.”
Regents of the Univ. of California v. Burwell, 155 F. Supp. 3d 31 (D.D.C. 2016). “As relevant here, the PRRB concluded that under 42 C.F.R. § 405.1867 , the regulation defining its legal authority, it was “bound to apply 42 C.”
Clarian Health West, LLC v. Eric Hargan, 878 F.3d 346 (D.C. Cir. 2017). “”); 42 C.F.R. § 405.1867 (explaining that the Board must “afford great weight” to CMS policy statements, but is not bound by such statements as it is by regulations).”
Mountain States Health All. v. Sebelius, 128 F. Supp. 3d 195 (D.D.C. 2015). “1837. The Board is bound by the Secretary’s regulations and “shall afford great weight to interpretive rules, general statements of policy, and rules of agency organization, procedure, or practice established by CMS,” including the PRM.”
Select Specialty Hosp.-Bloomington, Inc. v. Sebelius, 774 F. Supp. 2d 332 (D.D.C. 2011). “See 42 C.F.R. § 405.1867 (Board must comply with Title 18 and all regulations promulgated under it).”
Bayshore Cmty. Hosp. v. Azar, 325 F. Supp. 3d 18 (D.C. Cir. 2018). “], at 19 (citing 42 C.F.R. § 405.1867 ). 5 In other words, the Board was not at liberty to apply Banner Heart even if it wanted to do so.”
Dist. Hosp. Partners, Lp v. Sebelius, 794 F. Supp. 2d 162 (D.D.C. 2011). “See 42 C.F.R. § 405.1867 . Thus, providers may “file a request for a determination by the Board of its authority to decide the question of law or regulations relevant to the matter in controversy.”
Stevens Park Osteopathic Hosp., Inc. v. United States, 225 Ct. Cl. 113 (Ct. Cl. 1980). “In both instances, on appeal from the board, the deputy administrator reversed stating first that the board had exceeded its authority under 42 C.F.R. §405.1867 , which regulation requires the board to comply with Title XVIII of the Social Security Act and the regulations issued…”
Russell-Murray Hospice, Inc. v. Sebelius, 724 F. Supp. 2d 43 (D.D.C. 2010). “See 42 C.F.R. § 405.1867 (stating that the PRRB’s authority is constrained by the provisions of the Medicare statute and the regulations issued thereunder).”
Lenox Hill Hosp. v. Shalala, 131 F. Supp. 2d 136 (D.D.C. 2000). “On September 3, 1997, plaintiffs requested that the Board certify their cases for EJR, asserting that 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…”
Bayshore Cmty. Hosp. v. Hargan, 285 F. Supp. 3d 9 (D.C. Cir. 2017). “at 6 (citing 42 C.F.R. § 405.1867 ). Reviewing the procedural history of the matter before it and treating the self-disallowance regulation as valid, the Board determined it lacked jurisdiction to review Plaintiffs' appeal because Plaintiffs had not complied with the…”
E. Tex. Med. Ctr.-Athens v. Azar, 337 F. Supp. 3d 1 (D.C. Cir. 2018). “JA 11 (footnotes omitted) (first quoting 42 C.F.R. § 405.1867 ; then quoting Kennecott Utah Copper Corp.”
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