42 C.F.R. § 426.455 Prohibited provisions of an ALJ's decision.
Title 42 - Public Health
An ALJ's decision may not do any of the following: (a) Order CMS or its contractors to add any language to a provision or provisions of an LCD. (b) Order CMS or its contractors to pay a specific claim. (c) Set a time limit for CMS or its contractors to establish a new or revised LCD. (d) Review or evaluate an LCD other than the LCD under review. (e) Include a requirement for CMS or its contractors that specifies payment, coding, or systems changes for an LCD, or deadlines for implementing these types of changes. (f) Order or address how a contractor(s) must implement an LCD.
Title 42: Public Health
PART 426—REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS
Subpart D—Review of an LCD
§ 426.455 Prohibited provisions of an ALJ's decision.
