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Office of Hearings and Appeals

Volume I

Transmittal No. I-1-51

Chapter: I-1-0

Subject: Introduction to HALLEX


OHA's Special Counsel Staff (SCS) no longer exists. In October 2003, SCS merged with the Office of General Law in the Office of the General Counsel.

The Circuit Court Case Reporter (CCCR), maintained by the former SCS, is obsolete and is being removed from HALLEX, Volume II, Part 1. Part 1 will be reserved for future use.

In the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), Congress mandated that SSA transfer its responsibility for adjudicating Medicare appeals to the Department of Health and Human Services (HHS) between July 1, 2005 and October 1, 2005. HALLEX contains a Chapter to house Temporary Instructions (TI) for processing Medicare cases. Currently there is only one TI in this chapter, TI I-5-5-2 (Medicare Payment for Services Rendered in a Noncertified Bed (Hospital or Skilled Nursing Facility)) which was issued on April 12, 1985. The TI is outdated and has served its intended purpose and is deleted. Chapter I-5-5 (Health Care Financing Administration Matters) is being removed and reserved for future use.

Explanation of Content and Changes

This transmittal updates Chapter I-1-0 (Introduction to HALLEX) to delete references to the OHA Circuit Court Case Reporter and reflect that chapter 5-5 of the Temporary Instructions (Centers for Medicare and Medicaid Services Matters (formerly Health Care Financing Administration Matters) is being eliminated and reserved for future use. References to OHA's Special Counsel Staff are also deleted.

Section I-1-9 (Index) is outdated. Because a HALLEX user can locate specific information either by consulting the Table of Contents or through the “search” feature in PolicyNet, the outdated index is being removed. Section I-1-9 will be reserved for future use.

Date: June 21, 2005