Federal (United States) · Regulations
Subpart B — Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals
21 sections
21 sections
- 42 C.F.R. § 478.10Scope.
- 42 C.F.R. § 478.12Statutory basis.
- 42 C.F.R. § 478.14Applicability.
- 42 C.F.R. § 478.15QIO review of changes resulting from DRG validation.
- 42 C.F.R. § 478.16Right to reconsideration.
- 42 C.F.R. § 478.18Location for submitting requests for reconsideration.
- 42 C.F.R. § 478.20Time limits for requesting reconsideration.
- 42 C.F.R. § 478.22Good cause for late filing of a request for a reconsideration or hearing.
- 42 C.F.R. § 478.24Opportunity for a party to obtain and submit information.
- 42 C.F.R. § 478.26Delegation of the reconsideration function.
- 42 C.F.R. § 478.28Qualifications of a reconsideration reviewer.
- 42 C.F.R. § 478.30Evidence to be considered by the reconsideration reviewer.
- 42 C.F.R. § 478.32Time limits for issuance of the reconsidered determination.
- 42 C.F.R. § 478.34Notice of a reconsidered determination.
- 42 C.F.R. § 478.36Record of reconsideration.
- 42 C.F.R. § 478.38Effect of a reconsidered determination.
- 42 C.F.R. § 478.40Beneficiary's right to a hearing.
- 42 C.F.R. § 478.42Submitting a request for a hearing.
- 42 C.F.R. § 478.44Determining the amount in controversy for a hearing.
- 42 C.F.R. § 478.46Medicare Appeals Council and judicial review.
- 42 C.F.R. § 478.48Reopening and revision of a reconsidered determination or a decision.