Office of the Attorney Advisor |
Administrator's Review
Under section 1878 of the Social Security Act and the regulations at 42 CFR 405.1875, the Administrator of the Centers for Medicare & Medicaid Services (CMS) has the authority to review decisions rendered by the Provider Reimbursement Review Board and to issue final agency decisions for the Secretary of the Department of Health and Human Services (DHHS). This authority has also been delegated to the Deputy Administrator of CMS.
The Administrator has the authority, either on his or her own motion or at the request of a party or CMS, to review a Board decision. This review authority includes a decision under 42 CFR 405.1873 concerning the Board's jurisdiction to grant a hearing.
When the Administrator decides to review a Board decision, the Administrator has 60 days from the date of the provider's receipt of the Board's decision in which to reverse, affirm, or modify the decision. In addition, the Administrator may remand a case to the Board for further proceedings within the 60-day statutory timeframe. The procedures and criteria for Board determination and appeals are located at 42 CFR 405.1802, et seq. The rules relating specifically to the Administrator's review are found at 42 CFR 405.1875.
The Office of the Attorney Advisor (OAA) assists the Administrator in review of decisions rendered by the Board. All correspondence regarding Administrator review should be addressed to:
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Office of the Attorney Advisor
Centers for Medicare & Medicaid Services
Department of Health and Human Services
C3-01-20
7500 Security Boulevard
Baltimore, MD 21244-1850
Telephone number: 410-786-3176
Facsimile number: 410-786-0043
(Please call to confirm receipt of facsimile.)
Effective July 16, 2003, we began posting our Review Decisions on this web site. For decisions issued before July 16, please continue to use the contact phone number and address listed above. For decisions issued after July 16, please use the link below to go to the page that interests you.
View the Administrator Decision Review Index
View the latest actions taken by CMS to implement
The Medicare Prescription Drug, Improvement and Modernization Act of 2003
View and/or send email comments on CMS regulations with an open comment period published beginning January 30, 2004.
View CMS regulations with an open comment period published before January 30, 2004, at Regulations.gov.
