§ 426.405 Authority of the ALJ. ( a ) An ALJ conducts a fair and impartial hearing, avoids unnecessary delay, maintains order, and ensures that all proceedings are recorded.
( b ) An ALJ defers only to reasonable findings of fact, reasonable interpretations of law, and reasonable applications of fact to law by the Secretary.
( c ) The ALJ has the authority to do any of the following: ( 1 ) Review complaints by an aggrieved party (or aggrieved parties).
( 2 ) Dismiss complaints that fail to comply with § 426.400.
( 3 ) Set and change the date, time, and place of a hearing upon reasonable notice to the parties.
( 4 ) Continue or recess a hearing for a reasonable period of time.
( 5 ) Hold conferences to identify or simplify the issues, or to consider other matters that may aid in the expeditious disposition of the proceeding.
( 6 ) Consult with scientific and clinical experts on his or her own motion concerning clinical or scientific evidence.
( 7 ) Set schedules for submission of exhibits and written reports of experts.
( 8 ) Administer oaths and affirmations.
( 9 ) Examine witnesses.
( 10 ) Issue subpoenas requiring the attendance of witnesses at hearings as permitted by this part.
( 11 ) Issue subpoenas requiring the production of existing documents before, and relating to, the hearing as permitted by this part.
( 12 ) Rule on motions and other procedural matters.
( 13 ) Stay the proceedings in accordance with § 426.340.
( 14 ) Regulate the scope and timing of documentary discovery as permitted by this part.
( 15 ) Regulate the course of a hearing and the conduct of representatives, parties, and witnesses.
( 16 ) Receive, rule on, exclude, or limit evidence, as provided in § 426.340.
( 17 ) Take official notice of facts, upon motion of a party.
( 18 ) Decide cases, upon the motion of a party, by summary judgment when there is no disputed issue of material fact.
( 19 ) Conduct any conference, argument, or hearing in person or, upon agreement of the parties, by telephone, picture-tel, or any other means.
( 20 ) Issue decisions.
( 21 ) Exclude a party from an LCD review for failure to comply with an ALJ order or procedural request without good cause shown.
( 22 ) Stay the proceedings for a reasonable time when all parties voluntarily agree to mediation or negotiation, and provide mediation services upon request.
( d ) The ALJ does not have authority to do any of the following under this part: ( 1 ) Conduct an LCD review or conduct LCD hearings on his or her own motion or on the motion of a nonaggrieved party.
( 2 ) Issue a decision based on any new evidence without following § 426.340, regarding procedures for review of new evidence.
( 3 ) Review any decisions by contractors to develop a new or revised LCD.
( 4 ) Conduct a review of any draft, retired, archived, template, or suggested LCDs.
( 5 ) Conduct a review of any policy that is not an LCD, as defined in § 400.202 of this chapter.
( 6 ) Conduct a review of any NCD according to section 1869(f)(1)(A)(i) of the Act.
( 7 ) Conduct a review of the merits of an unacceptable LCD complaint as discussed in § 426.410.
( 8 ) Allow participation by individuals or entities other than— ( i ) The aggrieved party and/or his/her representative;
( ii ) CMS and/or the contractor; and
( iii ) Experts called by the parties or the ALJ.
( 9 ) Compel the parties to participate in a mediation process or to engage in settlement negotiations.
( 10 ) Deny a request for withdrawal of a complaint by an aggrieved party.
( 11 ) Compel the contractor to conduct studies, surveys, or develop new information to support an LCD record.
( 12 ) Deny a contractor the right to reconsider, revise or retire an LCD.
( 13 ) Find invalid applicable Federal statutes, regulations, rulings, or NCDs.
( 14 ) Enter a decision specifying terms to be included in an LCD.