['Employee Benefits']

['Health Plans']

05/07/2026

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REGSENSE
Topic Search
Employee Benefits - Health Plans

§150.443 Standard of proof

RegSense Employee Benefits CFR Regulations Associate Benefits & Compensation Focus Area CFR Section Human Resources Health Plans USA

(a) In all cases before an ALJ—

(1) CMS has the burden of coming forward with evidence sufficient to establish a prima facie case;

(2) The respondent has the burden of coming forward with evidence in response, once CMS has established a prima facie case; and

(3) CMS has the burden of persuasion regarding facts material to the assessment; and

(4) The respondent has the burden of persuasion regarding facts relating to an affirmative defense.

(b) The preponderance of the evidence standard applies to all cases before the ALJ.

['Employee Benefits']

['Health Plans']

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