Code of Federal Regulations (alpha)

CFR /  Title 42  /  Part 425  /  Sec. 425.800 Preclusion of administrative and judicial review.

(a) There is no reconsideration, appeal, or other administrative or judicial review of the following determinations under this part:

(1) The specification of quality and performance standards under Sec. 425.500 and Sec. 425.502.

(2) The assessment of the quality of care furnished by an ACO under the performance standards established in Sec. 425.502.

(3) The assignment of Medicare fee-for-service beneficiaries under Subpart E of this part.

(4) The determination of whether an ACO is eligible for shared savings, and the amount of such shared savings, including the determination of the estimated average per capita Medicare expenditures under the ACO for Medicare fee-for-service beneficiaries assigned to the ACO and the average benchmark for the ACO under Sec. 425.602, Sec. 425.604, and Sec. 425.606.

(5) The percent of shared savings specified by the Secretary and the limit on the total amount of shared savings established under Sec. 425.604 and 425.606.

(6) The termination of an ACO for failure to meet the quality performance standards established under Sec. 425.502.

(b) [Reserved]