DECISION DISMISSING CASE

On June 24, 2005, I directed that a letter be sent to the aggrieved party explaining that additional information was needed to clarify whether his letter of February 28, 2004 was intended as a complaint challenging a Local Coverage Determination (LCD). The letter informed him what information was required in order to file an acceptable complaint to challenge an LCD. The letter also stated that, if he failed to respond by July 25, 2005, I would assume that he did not wish to challenge an LCD and would dismiss this case. As of the date of this decision, I have received no response from the aggrieved party.

Assuming the aggrieved party’s February 28 letter was intended as an LCD complaint, it is unacceptable because it does not contain the information specified at 42 C.F.R. § 426.400(c)(3), (4), (5), and (6). I have afforded him the opportunity to amend the complaint, as required by 42 C.F.R. § 426.410(c)(1). The aggrieved party has failed to submit an acceptable complaint within the timeframe I have established. Therefore, pursuant to 42 C.F.R. § 426.410(c)(2), I must issue a decision dismissing the complaint.

The regulations require that an administrative law judge’s (ALJ’s) decision contain certain provisions. 42 C.F.R. § 426.450. Pursuant to 42 C.F.R. § 426.450(a), my decision must include findings. Therefore, as required by 42 C.F.R. § 426.450(a)(3), I find that the aggrieved party has failed to file an acceptable complaint challenging an LCD. Accordingly, for the reasons set forth above, I decide that this case must be dismissed.

The regulations, at 42 C.F.R. § 426.450(b), require that an ALJ’s decision contain certain other information. This decision contains the information required by 42 C.F.R. § 426.450(b)(1), (2), and (6). Because I am dismissing this case for failure to file an acceptable complaint, the information required by 42 C.F.R. § 426.450(b)(3), (4), and (5) is not a part of the record before me and is not included for that reason.

The aggrieved party has 30 days from the date of this Decision to file an appeal with the Departmental Appeals Board, in accordance with 42 C.F.R. § 426.465.