45 C.F.R. § 13 app A to Part 13

Current through October 31, 2024
Appendix A to Part 13 - Appendix A to Part 13

Proceedings covered Statutory authority Applicable regulations
Office of Inspector General
1. Proceedings to impose civil monetary penalties, assessments, or exclusions from Medicare and State health care programs42 U.S.C. 1320a -7a(c)(2); 1320b -10(c); 1395i -3(b)(3)(B)(ii), (g)(2)(A)(i); 1395 l(h)(5)(D), (i)(6); 1395m(a)(11)(A), (a)(18), (b)(5)(C), (j)(2)(A)(iii); 1395u(j)(2), (k), (l)(3), (m)(3), (n)(3), (p)(3)(A); 1395y(b)(3)(C), (b)(6)(B); 1395cc(g); 1395dd(d)(1)(A), (B); 1395mm(i)(6)(B); 1395nn(g)(3), (4); 1395ss(d); 1395bbb(c)(1); 1396b(m)(5)(B); 1396r(b)(3)(B)(ii), (g)(2)(A)(i); 1396t(i)(3); 11131(c); 11137(b)(2) 42 CFR part 1003 ; 42 CFR part 1005 .
2. Appeals of exclusions from Medicare and State health care programs and/or other programs under the Social Security Act42 U.S.C. 1320a -7(f); 1395 l(h)(5)(D); 1395m(a)(11)(A), (b)(5)(C); 1395u(j)(2), (k), (l)(3), (m)(3), (n)(3), (p)(3)(B) 42 CFR part 1001 ; 42 CFR part 1005 .
3. Appeal of exclusions from programs under the Social Security Act, for which services may be provided on the recommendation of a Peer Review Organization42 U.S.C. 1320c - 5(b)(4), (5) 42 CFR part 1004 ; 42 CFR part 1005 .
4. Proceedings to impose civil penalties and assessments for false claims and statements31 U.S.C. 3803 45 CFR part 79 .
Centers for Medicare & Medicaid Services
1. Proceedings to suspend or revoke licenses of clinical laboratories42 U.S.C. 263a(i) ; 1395w-2 42 CFR part 493, Subpart R.
2. Proceedings provided to a fiscal intermediary before assigning or reassigning Medicare providers to a different fiscal intermediary42 U.S.C. 1395h(e)(1)-(3) 42 CFR 421.114 , 421.128 .
3. Appeals of determinations that an institution or agency is not a Medicare provider of services, and appeals of terminations or nonrenewals of Medicare provider agreements42 U.S.C. 1395cc(h) ; 1395dd(d)(1)(A) 42 CFR 489.53(d) ; 42 CFR part 498 .
4. Proceedings before the Provider Reimbursement Review Board when Department employees appear as counsel for the intermediary42 U.S.C. 1395oo 42 CFR part 405, Subpart R.
5. Appeals of CMS determinations that an intermediate care facility for the mentally retarded (ICFMR) no longer qualifies as an ICFMR for Medicaid purposes42 U.S.C. 1396i 42 CFR part 498 .
6. Proceedings to impose civil monetary penalties, assessments, or exclusions from Medicare and State health care programs42 U.S.C. 1395i -3(h)(2)(B)(ii); 1395 l(q)(2)(B)(i); 1395m(a)(11)(A), (c)(4)(C); 1395w-2(b)(2)(A); 1395w-4(g)(1), (g)(3)(B), (g)(4)(B)(ii); 1395nn(g)(5); 1395ss(a)(2), (p)(8), (p)(9)(C), (q)(5)(C), (r)(6)(A), (s)(3), (t)(2); 1395bbb(f)(2)(A); 1396r(h)(3)(C)(ii); 1396r-8(b)(3)(B), (C)(ii); 1396t(j)(2)(C); 1396u(h)(2) 42 CFR part 1003 .
7. Appeals of exclusions from Medicare and State health care programs and/or other programs under the Social Security Act42 U.S.C. 1395 l(q)(2)(B)(ii); 1395m(a)(11)(A), (c)(5)(C); 1395w-4(g)(1), (g)(3)(B), (g)(4)(B)(ii) 42 CFR part 498 ; 42 CFR 1001.107 .
Food and Drug Administration
1. Proceedings to withdraw approval of new drug applications21 U.S.C. 355(e) 21 CFR part 12 ; 21 CFR 314.200 .
2. Proceedings to withdraw approval of new animal drug applications and medicated feed applications21 U.S.C. 360b(e), (m) 21 CFR part 12 ; 21 CFR part 514, Subpart B.
3. Proceedings to withdraw approval of medical device premarket approval applications 21 U.S.C. 306e(e), (g) 21 CFR part 12.
Office for Civil Rights
1. Proceedings to enforce Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color or national origin by recipients of Federal financial assistance42 U.S.C. 2000d-1 45 CFR 80.9 .
2. Proceedings to enforce section 504 of the Rehabilitation Act of 1973, which prohibits discrimination on the basis of handicap by recipients of Federal financial assistance29 U.S.C. 794a ; 42 U.S.C. 2000d-1 45 CFR 84.61 .
3. Proceedings to enforce the Age Discrimination Act of 1975, which prohibits discrimination on the basis of age by recipients of Federal financial assistance42 U.S.C. 6104(a) 45 CFR 91.47 .
4. Proceedings to enforce Title IX of the Education Amendments of 1972, which prohibits discrimination on the basis of sex in certain education programs by recipients of Federal financial assistance20 U.S.C. 1682 45 CFR 86.71 .

45 C.F.R. 13 app A to Part 13

69 FR 2847 , Jan. 21, 2004