Medicare Managed Care Manual (Pub. 100-16), Ch. 14 § 20.10
The Hearing Officer's Decision
20.10 - The Hearing Officer's Decision
(Rev. 122, Issued: 05-27-16, Effective: 06-28-16, Implementation: 06-28-16)
The hearing officer issues a written decision notice as soon as practical after the close of
a hearing and provides a copy of the written decision to each party. The decision must:
•
Be based upon the evidence presented at the hearing or otherwise included in
the hearing record; and
•
Contain separately numbered findings of fact and conclusions of law.
The hearing decision is final and binding on the contract applicant/MAO and on CMS
unless it is reversed or modified by the CMS Administrator following review or reopened
and revised. Additionally, the decision is made public.
Notice of any decision favorable to the MAO appealing a determination that is not
qualified to enter into a contract with CMS must be issued by September 1 to guarantee
that the contract in question will be effective on January 1 of the following year.