42 Public Health 2 2005-10-01 2005-10-01 false Action of the MAC. 405.1128 Section 405.1128 Public Health CENTERS FOR MEDICARE& MEDICAID SERVICES,DEPARTMENT OF HEALTH ANDHUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Determinations, Redeterminations, Reconsiderations, and Appeals Under Original Medicare (Part A and Part B) Medicare Appeals Council Review
§ 405.1128 Action of the MAC.

(a) After it has reviewed all the evidence in the administrative record and any additional evidence received, subject to the limitations on MAC consideration of additional evidence in § 405.1122, the MAC will make a decision or remand the case to an ALJ.

(b) The MAC may adopt, modify, or reverse the ALJ hearing decision or recommended decision.

(c) The MAC mails a copy of its decision to all the parties at their last known addresses. For overpayment cases involving multiple beneficiaries where there is no beneficiary liability the MAC may choose to send written notice only to the appellant. In the event the decision will result in a payment to a provider or supplier, the Medicare contractor must issue any electronic or paper remittance advice notice to that provider or supplier.