Source: https://www.law.cornell.edu/cfr/text/42/422.660
Timestamp: 2015-10-05 08:37:13
Document Index: 281571052

Matched Legal Cases: ['art 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422', '§ 422']

42 CFR 422.660 - Right to a hearing, burden of proof, standard of proof, and standards of review. | US Law | LII / Legal Information Institute
CFR › Title 42 › Chapter IV › Subchapter B › Part 422 › Subpart N › Section 422.660 42 CFR 422.660 - Right to a hearing, burden of proof, standard of proof, and standards of review.
§ 422.660
A contract applicant that has been determined to be unqualified to enter into a contract with CMS under Part C of Title XVIII of the Act in accordance with § 422.501 and § 422.502.
An MA organization whose contract has been terminated under § 422.510 of this part.
An MA organization whose contract has not been renewed under § 422.506 of this part.
An MA organization who has had an intermediate sanction imposed in accordance with § 422.752(a) through (b) of this part.
An applicant that has been determined to be unqualified to offer a Specialized MA Plan for Special Needs Individuals.
Burden of proof, standard of proof, and standards of review at a hearing.
During a hearing to review a contract determination as described at § 422.641(a) of this subpart, the applicant has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of § 422.501 and § 422.502 of this part.
During a hearing to review a contract determination as described at § 422.641(b) of this subpart, the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of § 422.506 of this part.
During a hearing to review a contract determination as described at § 422.641(c) of this subpart, the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of § 422.510 of this part.
During a hearing to review the imposition of an intermediate sanction as described at § 422.750 of this part, the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of § 422.752 of this part.
During a hearing to review a determination as described at § 422.641(d) of this subpart, the applicant has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of §§ 422.2; 422.4(a)(1)(iv); 422.101(f); 422.107, if applicable; and 422.152(g) of this part.
Timing of favorable decisions.
Notice of any decision favorable to the MA organization appealing a determination that it is not qualified to enter into a contract with CMS must be issued by September 1 for the contract in question to be effective on January 1 of the following year.
[75 FR 19813, Apr. 15, 2010, as amended at 77 FR 22168, Apr. 12, 2012]
§ 422.660 Right to a hearing, burden of proof, standard of proof, and standards of review.
Right to a hearing. The following parties are entitled to a hearing:
(1) A contract applicant that has been determined to be unqualified to enter into a contract with CMS under Part C of Title XVIII of the Act in accordance with §§ 422.501 and 422.502.
(2) An MA organization whose contract has been terminated in accordance with § 422.510.
(3) An MA organization whose contract has not been renewed in accordance with § 422.506.
(4) An MA organization who has had an intermediate sanction imposed in accordance with § 422.752(a) through (b) of this part.
(5) An applicant that has been determined to be unqualified to offer a Specialized MA Plan for Special Needs Individuals.
Burden of proof, standard of proof, and standards of review at a hearing. (1) During a hearing to review a contract determination as described at § 422.641(a) of this subpart, the applicant has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of §§ 422.501 and 422.502 of this part.
(2) During a hearing to review a contract determination as described at § 422.641(b) of this subpart, the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of § 422.506 of this part.
(3) During a hearing to review a contract determination as described at § 422.641(c) of this subpart, the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of § 422.510 of this part.
(4) During a hearing to review the imposition of an intermediate sanction as described at § 422.750, the MA organization has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of § 422.752(a) and (b).
(5) During a hearing to review a determination as described at § 422.641(d) of this subpart, the applicant has the burden of proving by a preponderance of the evidence that CMS' determination was inconsistent with the requirements of §§ 422.2; 422.4(a)(1)(iv); 422.101(f); 422.107, if applicable; and 422.152(g) of this part.
Timing of favorable decisions. Notice of any decision favorable to the MA organization appealing a determination that it is not qualified to enter into a contract with CMS must be issued by September 1 for the contract in question to be effective on January 1 of the following year.
[75 FR 19813, Apr. 15, 2010, as amended at 77 FR 22168, Apr. 12, 2012; 80 FR 7962, Feb. 12, 2015]