42 C.F.R. § 405.1804

Current through October 31, 2024
Section 405.1804 - Matters not subject to administrative and judicial review under prospective payment

Neither administrative nor judicial review is available for controversies about the following matters:

(a) The determination of the requirement, or the proportional amount, of the budget neutrality adjustment in the prospective payment rates required under section 1886(e)(1) of the Social Security Act.
(b) The establishment of-
(1) Diagnosis related groups (DRGs);
(2) The methodology for the classification of inpatient discharges within the DRGs; or
(3) Appropriate weighting factors that reflect the relative hospital resources used with respect to discharge within each DRG.

42 C.F.R. §405.1804

49 FR 322, Jan. 1, 1984, as amended at 78 FR 75195 , Dec. 10, 2013