Quality Improvement Organization Manual (Pub. 100-10), Ch. 9 § 9040.1
Unresolved and Affirmed Findings
9040.1 – Unresolved and Affirmed Findings
(Rev. 24, Issued: 02-12-16, Effective: 03-14-16, Implementation: 03-14-16)
If the final finding affirms the initial finding(s) or the initial finding is not otherwise
resolved (See §9035 above), the QIO must:
A. Submit a report of its final finding and sanction recommendation to OIG.
B. Send the affected practitioner or other person a concurrent final notice, with a
copy of all the material that is being forwarded to OIG, advising that:
1. The QIO has submitted its report and recommendation to OIG.
2. The practitioner or other person has 30 days after receiving the final
notice to submit any additional written material or documentary
evidence to OIG at its headquarters location, including that the date of
receipt is presumed to be 5 days after the date on the notice unless
there is a reasonable showing to the contrary.
3. Due to the 120-day statutory requirement specified in 42 CFR
§1004.100(e), the period for submitting additional information will not
be extended, and any material that OIG receives after the 30-day
period will not be considered.
C. Provide notice to the State medical board or to other appropriate licensing
boards for other practitioner types when it submits the report and
recommendations to OIG with respect to a physician or other person whom the
board is responsible for licensing. (See 42 CFR §1004.70.)