42 CFR 498.74 : Public Health (Part 1 To Parts 1009-1099) — (§ 482.1 To Parts 1009-1099) — Centers For Medicare & Medicaid Services, Department Of Health And Human Services (Continued) (§ 482.1 To Parts 601-699) — Standards And Certification (§ 482.1 To § 498.103) — Appeals Procedures For Determinations That Affect Participation In The Medicare Program And For Determinations That Affect The Participation Of Icfs/Iid And Certain Nfs In The Medicaid Program (§ 498.1 To § 498.103) — Hearings (§ 498.40 To § 498.79) — Administrative Law Judge's decision.

(a) Timing, basis and content. As soon as practical after the close of the hearing, the ALJ issues a written decision in the case. The decision is based on the evidence of record and contains separate numbered findings of fact and conclusions of law.

(b) Notice and effect. A copy of the decision is mailed to the parties and is binding on them unless -

(1) A party requests review by the Departmental Appeals Board within the time period specified in § 498.82, and the Board reviews the case;

(2) The Departmental Appeals Board denies the request for review and the party seeks judicial review by filing an action in a United States District Court or, in the case of a civil money penalty, in a United States Court of Appeals;

(3) The decision is revised by an ALJ or the Departmental Appeals Board; or

(4) The decision is a recommended decision directed to the Board.