Guidelines

Guidelines for appellate review of decisions of ALJs supported by the DAB’s Civil Remedies Division:

• Affecting a Provider’s Participation in the Medicare and Medicaid Programs
• In Cases under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and Related Statutes
• Affecting a Provider’s or Supplier’s Enrollment in the Medicare Program
• In Cases to which Procedures in 42 C.F.R. Part 1005 Apply
• In Social Security Administration Cases to which Procedures in 20 C.F.R. Part 498 Apply
• Relating to Imposition of Civil Money Penalties Based on Violations of the HIPAA Administrative Simplification Provisions
• Under the Program Fraud Civil Remedies Act of 1986
• Relating to Imposition of Civil Money Penalties Based on Violations of the Confidentiality Provisions of the Patient Safety and Quality Act
• In Food and Drug Administration Cases Other Than Tobacco Products Cases
• In Food and Drug Administration Tobacco Products Cases

Guidelines for appellate review of decisions of ALJs at the Department of the Interior Office of Hearings and Appeals:

• In Indian Self-Determination Act Declinations
• In Pre-Award Disputes under Title V of the Indian Self-Determination and Education Assistance Act

Other guidelines:

• Civil Rights Reviewing Authority Review of Civil Rights Enforcement Decisions for HHS Programs
• Review of Initial Decisions on Fee Applications Under the Equal Access to Justice Act