Hearings by an Administrative Law Judge - (Rev. 4, 07-18-03)

7560 - Hearings by an Administrative Law Judge - (Rev. 4, 07-18-03) A. Beneficiary Representatives at Hearings A Medicare beneficiary may appoint any person to represent him/her who meets the requirements of regulations in 20 CFR 404.1705(b), including a provider/practitioner who furnished the services at issue in the appeal. The representative must:  Be generally known to have a good character and reputation;  Be capable of giving valuable help to the beneficiary in connection with the claim;  Not be disqualified or suspended from acting as a representative in dealings with OHA; and  Not be prohibited by any law from acting as a representative. The beneficiary appoints a provider/practitioner by signing an "Appointment of Representative" form (CMS-1696-U4) (See Exhibit 7-68). B. Your Participation in the Hearing Process Neither you nor CMS have the right to appear or participate in the hearing process because you are not designated as parties in the Social Security Act (See 20 CFR 404.932). However, in order to conduct full and fair hearings, ALJs may call your staff to appear as witnesses and to explain your procedures and determinations. C. Disclosure of Information for Administrative Hearings When a Medicare beneficiary, physician, or provider, who is filing for a hearing by an ALJ, requests you to provide information on your reconsideration determination, disclose the information in accordance with the limitations specified in the regulations at 42 CFR 480.139(b)(2). These regulations require you to disclose detailed facts, findings, and conclusions. Your deliberations, however, are not disclosable, either in written form or through oral testimony. Before disclosing information remove any identification of practitioners, reviewers, or other patients unless each individual gives consent to the disclosure. D. Retention of Appeals Files After ALJ Hearings Fiscal intermediaries maintain appeal files when the appeal is completed. Maintain your copy of the record (i.e., file) of the appeal until the later of:  Four years after the date on the notice of your reconsideration determination; or  Completion of litigation and the passage of the time period for filing all appeals (see §7430.H). NOTE: ALJ decisions are sent to the CMS respective Regional Office (RO).