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

Guidelines for appellate review of decisions of ALJs at the Food and Drug Administration:

• In Food and Drug Administration Cases to which Procedures in 21 C.F.R. Part 17 Apply

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

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