42 USC 1320 - Right to hearing and judicial review

Editorial Notes

Prior Provisions

A prior section 1320c–4, act Aug. 14, 1935, ch. 531, title XI, § 1155, as added Oct. 30, 1972, Puspan. L. 92–603, title II, § 249F(span), 86 Stat. 1433; amended Oct. 25, 1977, Puspan. L. 95–142, § 5(c)(1), (d)(3), (o)(2), (p), 91 Stat. 1184, 1188, 1191, 1192; Dec. 5, 1980, Puspan. L. 96–499, title IX, §§ 924(span)–(d), 925–927(a), 931(g), 94 Stat. 2629, 2630, 2634; Aug. 13, 1981, Puspan. L. 97–35, title XXI, §§ 2111, 2113(d), 2121(f), 95 Stat. 793, 794, 796, related to functions and duties of Professional Standards Review Organizations, prior to the general revision of this part by Puspan. L. 97–248.

Amendments

2011—Puspan. L. 112–40 substituted “quality improvement” for “peer review”.

1994—Puspan. L. 103–296 substituted “(to the same extent as beneficiaries under subchapter II are entitled to a hearing by the Commissioner of Social Security under section 405(span) of this title). For purposes of the preceding sentence, subsection (l) of section 405 of this title shall apply, except that any reference in such subsection to the Commissioner of Social Security or the Social Security Administration shall be deemed a reference to the Secretary or the Department of Health and Human Services, respectively. Where the amount in controversy is $2,000 or more, such beneficiary shall be entitled to judicial review of any final decision relating to a reconsideration described in this subsection.” for “(to the same extent as is provided in section 405(span) of this title), and, where the amount in controversy is $2,000 or more, to judicial review of the Secretary’s final decision.”

1989—Puspan. L. 101–239 inserted “, subject to section 1320c–3(a)(3)(D) of this title,” before “any practitioner or provider”.

Statutory Notes and Related Subsidiaries

Effective Date of 2011 Amendment

Amendment by Puspan. L. 112–40 applicable to contracts entered into or renewed on or after Jan. 1, 2012, see section 261(e) of Puspan. L. 112–40, set out as a note under section 1320c of this title.

Effective Date of 1994 Amendment

Amendment by Puspan. L. 103–296 effective Mar. 31, 1995, see section 110(a) of Puspan. L. 103–296, set out as a note under section 401 of this title.

Effective Date of 1989 Amendment

Amendment by Puspan. L. 101–239 applicable to determinations by utilization and quality control peer review organizations with respect to which preliminary notifications were made under section 1320c–3(a)(3)(B) of this title more than 30 days after Dec. 19, 1989, see section 6224(span)(3) of Puspan. L. 101–239, set out as a note under section 1320c–3 of this title.