C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 498—APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN THE MEDICARE PROGRAM AND FOR DETERMINATIONS THAT AFFECT THE PARTICIPATION OF ICFs/IID AND CERTAIN NFs IN THE MEDICAID PROGRAM › Subpart E—Departmental Appeals Board Review

42 C.F.R. § 498.90

Effect of Departmental Appeals Board decision

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(a) General rule. The Board's decision is binding unless—

(1) The affected party has a right to judicial review and timely files a civil action in a United States District Court or, in the case of a civil money penalty, in a United States Court of Appeals; or

(2) The Board reopens and revises its decision in accordance with § 498.102.

(b) Right to judicial review. Section 498.5 specifies the circumstances under which an affected party has a right to seek judicial review.

(c) Special rules: Civil money penalty—(1) Finality of Board's decision. When CMS imposes a civil money penalty, notice of the Board's decision (or denial of review) is the final administrative action that initiates the 60-day period for seeking judicial review.

(2) Timing for collection of civil money penalty. For SNFs and NFs, the rules that apply are those set forth in subpart F of part 488 of this chapter.

[61 FR 32351, June 24, 1996]
Notes of Decisions
Cited in 17 cases (1 in the last 5 years), 2000–2024 · leading case: Sunshine Haven Nursing Operations, LLC v. United States Dep't of Health & Human Servs., Centers for Medicare & Medicaid Servs., 742 F.3d 1239 (10th Cir. 2014).
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Sunshine Haven Nursing Operations, LLC v. United States Dep't of Health & Human Servs., Centers for Medicare & Medicaid Servs., 742 F.3d 1239 (10th Cir. 2014). · cites it 3× “90 (a)(1) In its supplemental brief, Sunshine argues that § 1320a-7a(e) confers jurisdiction on this court over all of the issues in its petition for review because challenges to CMPs are involved and that jurisdiction lies in the district court under § 1395ec(h)(l)(A) only if…”
Crestview Parke Care Ctr. v. Tommy Thompson United States Dep't of Health & Human Servs., 373 F.3d 743 (6th Cir. 2004). “See also 42 C.F.R. § 498.90 (a)(1). II. ANALYSIS Crestview presents several different issues on appeal.”
Livingston Care Ctr. v. United States Dep't of Health & Human Servs., 388 F.3d 168 (6th Cir. 2004). “42 C.F.R § 498.90(c)(1). 4 . Under 42 C.F.”
Greenbrier Nursing & Rehab. Ctr. v. U.S. Dep't of Health & Human Servs., Centers for Medicare & Medicaid Servs., 686 F.3d 521 (8th Cir. 2012). · cites it 2× “The DAB’s decision on a civil money penalty is the final decision of the Secretary and is subject to judicial review in a United States Court of Appeals pursuant to 42 U.”
BP Care, Inc. v. Thompson, 337 F. Supp. 2d 1021 (S.D. Ohio 2003). · cites it 2× “He examined both § 1320a-7a(e) and 42 C.F.R. § 498.90 (a)(1), which provides that a DAB decision is final unless “[t]he affected party has a right to judicial review and timely files a civil action in a United States District Court or, in the case of a civil monetary penalty, in…”
Ahmed v. Sebelius, 710 F. Supp. 2d 167 (D. Mass. 2010). “42 C.F.R. § 498.90 . On August 31, 2009, Ahmed filed the complaint now before me, alleging that the Secretary’s revocation of his Medicare enrollment violated the Administrative Procedure Act (“APA”), the Medicare Act, and due process.”
Liberty Commons Nursing v. Leavitt, 285 F. App'x 37 (4th Cir. 2008). · cites it 2× “§ 1320a-7a(e); 42 C.F.R. § 498.90 (a)(1). For the reasons set forth below, we affirm the decision of the DAB.”
South Valley Health Care Ctr. v. Health Care Fin. Admin., 223 F.3d 1221 (10th Cir. 2000). “See 42 C.F.R. § 498.90 (a)(1). On review in this court, the Secretary’s findings of fact, “if supported by substantial evidence on the record considered as a whole, shall be conclusive.”
Cox Ret. Props., Inc. v. Johnson, 323 F. App'x 668 (10th Cir. 2009). “2000) (citing 42 C.F.R. § 498.90 (a)(1)). “Because the DAB affirm[ed] and adopt[ed] the ALJ’s decision, this court also reviews the ALJ’s decision as part of the Secretary’s final decision.”
SunBridge Care & Rehab. v. Leavitt, 340 F. App'x 929 (4th Cir. 2009). “§ 1320a-7a(e); 42 C.F.R. § 498.90 (c)(1). We exercise jurisdiction pursuant to 42 U.”
Woodstock Care Ctr. v. Thompson, 161 F. Supp. 2d 813 (S.D. Ohio 2001). “The exclusive nature of the Sixth Circuit’s jurisdiction to hear the present action is also reflected in 42 C.F.R. § 498.90 (a)(1), which provides that a decision of the DAB is final unless “[t]he affected party has a right to judicial review and timely files a civil action in a…”
Sunsites-Pearce Fire Dist. v. Azar (D. Ariz. 2020). “See 42 C.F.R. §§ 498.90 (a)(1), 498.5(f)(2). The district court 13 may then consider an appeal of the final decision of the Secretary “in the same manner as 14 is provided in 42 U.”
Show all 17 citing cases →
— 42 C.F.R. § 498.90(c)(1) — 2 cases
Livingston Care Ctr. v. United States Dep't of Health & Human Servs., 388 F.3d 168 (6th Cir. 2004). “42 C.F.R § 498.90(c)(1). 4 . Under 42 C.F.”
Livingston Care v. HHS (6th Cir. 2004).
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